If you live with insulin-dependent diabetes and manage your blood sugar levels with an insulin pen or syringe, you are likely taking more than twice a day insulin shots.
This is a minimum of 730 times a year when you stab your skin with a needle to give an injection.
I inject more than twice a day. I’m approaching 7 doses a day, which is not uncommon for diabetics. That’s 2,555 injections a year!
I don’t care, and it won’t hurt. But one of the main reasons it doesn’t harm is that I use the right needle, the right injection technique and frequently replace the needle.
In this article, you will learn how to choose the size of your needle or syringe to minimize pain, avoid scar tissue buildup, and ensure you receive the full dose every time you inject it.
What is a pen needle??
A pen needle is a needle that is prefilled or attached to a durable pen so that it can be injected with medication.
Common types of pen needles include standard pen needles and safety pen needles, with most people using standard pen needles.
You can watch this one-minute video to see exactly what the needle in your pen is.
Standard pen needles have an outer cover and a removable inner needle cover. Both must be removed before insulin flows.
Unfortunately, not everyone is being told that both covers need to be removed due to inadequate training. According to the FDA, this has led to severe increases in blood sugar levels and even hospitalisation for people born. So remove both covers and make sure you visually ensure that insulin flows.
Safety needles are slightly different. There is an outer cover that is removed before injection, but the inner cover is not removed. Push the safety needle into your skin and the inner cover goes back to reveal the needle.
The inner cover is not removed, protecting you from accidentally poking yourself in with a needle.
This type of needle is ideal if you are scared of the needle (as you can’t see the actual needle). Ideal if you have concerns about accidentally poking yourself with a needle.
Pen needle size
Insulin pen needles are available in a variety of sizes, ranging from 4 mm to 12.7 mm (5/32 inch to ½ inch).
Generally, the medical community is leaning towards using short needles, but ultimately you need to decide which needle size suits you.
Prescribing longer needles can make your first insulin injection a bit daunting, and even affect your desire to receive the injection as you were prescribed.
If so, reach out to your doctor and request another needle. Alternatively, if you don’t need a prescription (more on it later), buy the right size for you online or at your local pharmacy.
How do you know which size of insulin needle to use?
Since insulin and GLP-1 need to be injected subcutaneously (in the fat between the skin and muscles), you need to choose the easiest needle to do so.
On average, human skin is 1.9-2.4 mm thick, regardless of body size, gender, ethnicity or BMI. This means that short 4mm or 5mm needles are effective for all body types.
The International Scientific Advisory Committee says there is no medical reason to recommend needle lengths longer than 8 mm. The board recommends 4, 5, and 6 mm needles for all adult patients regardless of BMI.
That doesn’t mean you can’t use a longer needle, but using a longer needle can increase the chances of bruises, bleeding and pain.
When using long needles, there is also the risk of insulin being injected into the muscle (called intramuscular shots). If insulin is injected into the muscles instead of adipose tissue, it can absorb too quickly and lead to hypoglycemia.
Shorter needles are generally recommended, but there are certain circumstances in which longer needles can be a better option.
For example, if you have adjustment challenges due to a condition like arthritis or Parkinson’s disease, you can benefit from using a longer needle.
Needle Thickness – What is the transaction?
The needle thickness is measured in gauges (g) rather than in millimeters or inches. The needle on the pen ranges from 29 g to 32 g, and the higher the gauge, the thinner the needle.
The thickness of the pen needle is primarily relevant when injecting large amounts of insulin at once. This is because you need a low gauge needle that will allow more insulin to flow faster.
When to pinch the skin
There are various ways to successfully perform subcutaneous injections, and the appropriate technique comes down to the length of the needle you choose.
If the needle is 4 mm or 5 mm, the injection can be performed at a 90-degree angle. This means there is no need to pinch your skin, and injections can be performed with one hand if necessary. This is practical when injecting into your arms, waist, or glute.
Children aged 2-6 or very lean adults may need to use pinch-up techniques regardless of the length of the needle.
If you choose a needle longer than 5 mm, the injection must be performed at a pinched-up skinfold or at a 45-degree angle to avoid intramuscular injection of insulin.
What about leakage concerns related to short needles?
Some people raise concerns that a short needle leads to leakage (not fully injected with insulin), or that it is not suitable for people with a body.
That concern has been exposed, and studies show that shorter needles work for most body types and do not have additional leaks.
But if you feel a longer needle more comfortable, you should definitely do it.
How to get a pen needle or syringe
You might think you can buy a pen needle on the counter, but the short answer is that it depends.
In the US, prescription rules vary from state to state, and some states do not require a prescription to purchase a pen needle.
However, if you use insurance to pay the needle, you may need a prescription. Reach out to the insurance company to learn if you need a prescription and, if so, how much co-payments are available.
There is also the option to buy pen needles online without a prescription, but which solution is the most cost-effective for you and will depend on your insurance.
How to choose the right insulin syringe?
Using syringes for insulin injections is the most widely used method of supplying insulin in the United States.
The syringe is a hollow plastic tube with a plunger inside and a short, thin needle. Insulin must be withdrawn from the vial before injecting it using a syringe.
I would like to choose the right syringe for the type of insulin I use, but the first thing I’ll check is whether the insulin concentration matches the syringe.
The syringes (and packaging) show what insulin concentrations the syringes are intended for. Insulin concentrations are measured in units/ml and are indicated as U-100, U-200, or U-500.
Make sure your syringe matches your insulin concentration or is supposed to inject the wrong amount of insulin.
Secondly, you need to choose the right syringe size for you. If you use large amounts of insulin at once, you should choose a larger syringe so that you do not need to cut the dosage into small amounts.
- The 0.3 mL syringe is a dose of 30 units of insulin and is numbered at 1 unit intervals.
- A 0.5 mL syringe is a dose of 30-50 units of insulin and is numbered at 1 unit intervals.
- A 1.0 mL syringe is a dose of insulin of 50 units or more and is numbered at 2 unit intervals.
Finally, we’ll consider which size needles are right for you. As with pen needles, shorter needle sizes are generally recommended.
You can get a syringe with a needle at a length of 12.7 mm (1/2 inch), but the shortest available syringe needle length is 6 mm (15/64”) x 31g.
Good thrust practices
It is important to choose a needle or syringe that works for you, but injections will be more comfortable, as long as you remember too, with less risk of pain and leakage.
- I change the needle every time.
- Select the appropriate injection site and rotate the site.
- Do not jab the needle
- Hold for 5-10 seconds to reduce the risk of leakage.
Injecting insulin should be rarely painful if you choose the right needle size and follow appropriate injection practices. Once the pen needle or syringe is finished, don’t forget to dispose of it safely.
