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Blog: Are your patient re-using insulin pen device needles?

I wonder how many of you find that there are people using each needle on their insulin devices several times.

I must have been naive, not realising that so many are doing just this. Do they think they are saving the NHS money by re-using the needles on their insulin pen devices? I have even heard people say to me, that their nurse told them they could do that when they were first diagnosed (perhaps 15-20 years ago?). I find that hard to believe, but perhaps in the dim and distant past, needles were re-used, but had to be boiled first, prior to the disposable variety we now always use.

Why do we tell those who are injecting, be it a GLP1 or Insulin of some sort, that they must change their needle after a single use? There is a document on injection safety that quite clearly lays out all the reasons for the single use of needles (see Resources).

It’s definitely something to know about, so that when patients question us about why they should do this, we can clearly explain the risks and dangers of needle re-use. These are just a few of the key risk factors:

1.     Infection at injection site leading to an abscess.

2.     Lipohypertrophy.

3.     Poor insulin absorption due to blunt needle, possibly leading to constant increase in the dose of insulin required.

4.     Injection become more painful when an increasingly blunt needle is used.

If you knew all this, would you want to keep using the same needle?

When I ask patients how often they change their needles on their insulin device, they will say “once a day” when giving three or four injections, or “everytime I change the insulin cartridge”. They are then surprised at my response, which is: “why do you do this?”

On average, as I run clinics in the various surgeries which are my responsibility as a community diabetes specialist nurse, I come across two people a week who are re-using their needles. There is a very easy way to find out if this might be happening, by checking their repeat prescriptions because this will show if needles are not being re-ordered. If their blood glucose control is deteriorating and their insulin usage is increasing, then ask them how many times they use the needle of their insulin device. It is essential that we ensure that all our patients with diabetes do not re-use either their insulin device needles or repeat the use of their lancets.

Just a question before I finish this blog, what are your thoughts about the suggestions that Theresa May may not cope as Prime Minister because she has type 1 diabetes?

When first diagnosed she injected insulin twice daily, but now it has increased to four, which suggests she uses a Basal Bolus regime. She appears to be quite open about having the condition, and in the past few days it has been reported that she got up from a dinner function telling others to carry on and eat while she went to give her insulin.

Perhaps this will give much needed publicity to the problem of diabetes, as she will be one of the most, high profile people with type 1 diabetes in the UK. It will hopefully provide us with opportunities to explain to people the differences between type 1 and type 2 diabetes. She has used her personal experience of type 1 diabetes, as motivation to write to schools in her own Maidenhead constituency. This was in relation to Diabetes UK’s campaign to make sure schools understand how to support children with type 1 diabetes in their care legally and appropriately.

Resources

Injection Safety document –

trend-uk.org/documents/fit%203rd%20edition%20final%20copy.pdf