Diabetes Talking

Question:

Does anyone know what the benefits of short needles are? Does anyone out there use them?

I am 6 foot 1/2 inch tall with large bones and I weigh 175 pounds. I have problems finding fatty areas for subcutaneous insulin injections.  Some of my injections with the longer needles entered the muscle beneath causing the insulin to not be absorbed properly.  Despite measuring food consumption (I weigh my food) and insulin precisely, I would have unexplained high sugars.  The short needles helped. Remember to inject straight in with short needles rather than at an angle I started on a pump recently, and I’m having problems with infusion sets not working (same problem).  I’ve had really bad luck with the Soft-set QR infusion set.  Only 1 out of 7 lasted the full 3 days before I had to change it. I’m trying the Minimed Silhouette (MMT-373) with better results:  3 out of 5.  Except for the infusion sets, the Minimed pump is great for a digital diabetic like me. Insulin pumps are not for everybody. Steve

Response:

I had the same understanding…in fact, I *think* that the times I’ve had intense pain from injecting in my arm is when I hit muscle instead of fat. I thought that was why they taught me to pinch the skin first, to form that fatty target area, but it was so long ago, I always thought of it more as a way to make me concentrate on pinching so hard, I wouldn’t think of the needle going in!  :-) — ~ Mookie ~ T1 since 10/80, MDI – Humalog & Ultralente

– Hide quoted text — Show quoted text – I think it *might* be because a shorter needle might not reach through a thin layer of fat that some of us have.  If the insulin is suspended in that fat, it would be absorbed  at a much slower rate than it would be if it had been injected into muscle tissue. I understood that insulin wasn’t given IM and normally is injected into the fatty tissue layer and not into muscle???????

Response:

I was also told by my medical team that the insulin needs to be injected into the fatty tissue and not the muscle.  I’ve been using the short needles for several years now and find them to be much more comfortable than the long ones.  The only thing I’ve found you need to be careful about is injecting the insulin into the area just under the skin.  You know it when you do it.  You get a bubble.  This may cause the insulin to absorb abnormally or not at all. The key is to not pinch the skin when injecting and make sure you go straight in with the needle.  I’m not a "skinny" diabetic and I find these short needle syringes to work just as well as the long ones. Jenny J "just shoot me" injecting Humulin U and Humalog

Response:

I switched to short needles when the pharmacist suggested it.  I finally went back to the long needles because the insulin was leaking out so much. I don’t know if it was because of the short needles, but I certainly FELT more confident that it would leak less with a longer needle.  No difference in pain here either, and I still leak and bleed… but I still feel more confident that it happens LESS and ease of mind is certainly something gained. I also noticed that the long needles are cheaper for some reason. Funny thing is, when I wanted to go back to long needles, I had switched my prescription from one CVS to the 24 hour store near my house, and that pharmacist said I needed a new Rx from my doctor.  I said "I didn’t get one when I switched the first time, and if you look at the original prescription it doesn’t state short needles" I could have been wrong, had been using short needles for a few years, but I’d never asked my dr. to prescribe short needles specifically. Anyway, I gotta go to work.  Those are my thoughts/experiences with the short needles. Ahhh insulin injections… no pain, no gain sometimes! — ~ Mookie ~ T1 since 10/80, MDI – Humalog & Ultralente

– Hide quoted text — Show quoted text – I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? Thanks, Dave

Response:

: : I think it *might* be because a shorter needle might not reach through : a thin layer of fat that some of us have.  If the insulin is suspended : in that fat, it would be absorbed  at a much slower rate than it would : be if it had been injected into muscle tissue. : : : I understood that insulin wasn’t given IM and normally is injected into the : fatty tissue layer and not into muscle??????? This is what my nurse trainer told me. My weight varies a lot. I have long needles for when I am fatter and short needles for when it is hard to pinch a fold of skin. To tell you the truth, I don’t notice much difference on my blood sugars, but get more subcutaneous bleading when I use long needles. I do notice that in the summer, when I swim a mile a day or so, and my weight drops, that I have more trouble with lows with long needles. Mind you, I only have 2,5 years experience, being diagnosed type 1 at 47, John — Philosophy — U. of Newcastle                   Fax:   +61 49 216928 Callaghan, NSW, AUSTRALIA 2038  http://bcollier.newcastle.edu.au http://www.newcastle.edu.au/department/pl/Staff/JohnCollier/collier.html

Response:

- Hide quoted text — Show quoted text – I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? I tried them with just about the same results as you.  I don’t think they were any less painful either.   Still have about 90 of them left.  My guess is they may be fine for VERY skinny diabetics! Gary

Gary… as a skinny diabetic, i would suggest the short needles must have been made for kids……. i returned the 95 needles remaining in the box and got a new box of *my* needles…. the LONGER ones….. sheesh! — k t1 13 yrs (ps… the pharmacist changed them based on something the sales rep said….. was quite embarrassed as she thought she was *helping* me)

Response:

- Hide quoted text — Show quoted text – se them? I tried them with just about the same results as you.  I don’t think they were any less painful either.   Still have about 90 of them left.  My guess is they may be fine for VERY skinny diabetics! Gary If you plan to get rid of them, I suggest you consider donating them to a child receiving growth hormone. They are usually skin and bones. Carol Thank you, Good point, I will bring this up to my pharmacists.  I was looking for some one without insurance who used the short needles.  But a child without insurance is, IMO, a better choice. Thanks again, Gary

If you can’t find one easily you might contact Genentech based in San Diego. They have a program for uninsured children on GH. No child needing growth hormone does without regardless of ability to pay. They will know who may live near you and qualify. Or if because of privacy issues they can’t help,  you could contact the Magic Foundation http://www.magicfoundation.org/ which is a support group for families with children with any form of growth hormone disorder. Even without breeching privacy issues, I’m sure if you donated them, they would be able to pass them on to a needy child. But ask first just in case I have assumed incorrectly. Carol

Response:

How old are you? Sorry, I don’t mean to sound like a cop! But I tend to know most of the Type 1 stories on here, and I’m just not familiar with yours. Jennifer – Hide quoted text — Show quoted text – I don’t recall your "story", Gary. How long have you been Type 1? Jennifer DX’ed  in 1985

Response:

se them? I tried them with just about the same results as you.  I don’t think they were any less painful either.   Still have about 90 of them left.  My guess is they may be fine for VERY skinny diabetics! Gary

If you plan to get rid of them, I suggest you consider donating them to a child receiving growth hormone. They are usually skin and bones. Carol

Response:

I don’t recall your "story", Gary. How long have you been Type 1? Jennifer – Hide quoted text — Show quoted text – Gary, My A1c’s have dropped considerably since I started using the shorter needles (from 6.1 to 5.3). But I think that’s due more to the insulin change than the needle itself (I’ve also lost a considerable amount of weight in the last 3 years). Way to go……  For what ever reason! I’m a tummy injector. Mornings and before bed time, I am a leg man!!!!  Lunch and dinner time, I go for the tummy.  Typical male. I do think many things need to be considered besides the needle. I do too, but I can tell you it was a repeatable thing for me.  Short needles in the "tummy" and "R" will take longer to act.   I will test it next week when I get back off the road.  I will let you know what happens. I will say that I have less lumps in my skin since the switch to a shorter needle. Lumps have never been an issue with me as far as the length of the needle goes.  But then again I did not use the "shorts" all that long. Gary

Response:

Gary, My A1c’s have dropped considerably since I started using the shorter needles (from 6.1 to 5.3). But I think that’s due more to the insulin change than the needle itself (I’ve also lost a considerable amount of weight in the last 3 years). I’m a tummy injector. I do think many things need to be considered besides the needle. I will say that I have less lumps in my skin since the switch to a shorter needle. Jennifer Type 1, dx’d at 12 in 1978. – Hide quoted text — Show quoted text – I am not skinny, yet I do just fine with the short needle (been using them for 3 years). I didn’t get any special instruction from my medical team about using them. But maybe it would behoove you to ask your doctor about any special problems associated with them instead of just throwing them out. Oh I did, he tends to agree with me, although he was a bit surprised by magnitude of the difference.  It *may* be because I take the "cover my dinner" shot in the stomach.  Although I am not fat, I do have somewhat of a pot belly.   I think this may play a big part in it.  As far as throwing them out, they are still sitting on the top shelf of my closet.  Hoping to find someone who really needed them!  I have asked the pharmacy to keep an eye out for me. Did you see any difference at all when you changed?   Just out of curiosity, where do you inject? Gary

Response:

I can’t give a knowledgeable reply, not knowing biology. My guess is that the short needles inject subcutaneously (just under the skin), and the insulin then "leaks" into the bloodstream very slowly via the blood capillaries in that area.  Wouldn’t a longer needle inject into areas serviced by larger or more plentiful capillaries (the deeper a cut, the more it bleeds, no?) All you medical types out there, please advise. Dave – Hide quoted text — Show quoted text – Just a question here.  I don’t get what the difference would be.  Please explain how the length of the needle changes the way the insulin is absorbed?  It all goes in the same way, doesn’t it? Jennifer I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? Thanks, Dave

– Please send reply mail to: David Frank Professor of Chemistry CSU Fresno 559-278-2273 559-278-2103 (Chem Office) Fax: 559-278-4402

Response:

Just a question here.  I don’t get what the difference would be.  Please explain how the length of the needle changes the way the insulin is absorbed?  It all goes in the same way, doesn’t it? Jennifer – Hide quoted text — Show quoted text – I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? Thanks, Dave

Response:

I am not skinny, yet I do just fine with the short needle (been using them for 3 years). I didn’t get any special instruction from my medical team about using them. But maybe it would behoove you to ask your doctor about any special problems associated with them instead of just throwing them out. My two sents. Jennifer Type 1, dx’d at 12 in 1978. – Hide quoted text — Show quoted text – I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? I tried them with just about the same results as you.  I don’t think they were any less painful either.   Still have about 90 of them left.  My guess is they may be fine for VERY skinny diabetics! Gary

Response:

Does anyone know what the benefits of short needles are? Does anyone out there use them?

I use both long needles 1/2 CC and short needles 1/3 CC.  I can see absolutely no difference between the two.  I agree, though, it hurts just the same and I bleed just as much with either needle. Richard

Response:

I have recently switched HMOs to Kaiser and there was a mix-up in the Rx for needles. I wanted BD’s 0.3 cc 29 gauge, but was given the 0.5 cc needles instead. So I finally got to speak with the pharmacist, and told him what I needed, but he brought out a box of the new short needles from BD, also 0.3 cc but 30 gauge, and about half the length of the traditional insulin needle I had been using.  How about these, he offered. Cool, I thought. Less needle, less pain. Also, as it turned out, less control. I spiked dramatically after dinner if I did not go for a 20 min workout on the treadmill. It took a few days to work out the pattern, but my guess is that the insulin is *much* more slowly absorbed with these short needles. The effect can be offset with vigorus exercise. Clearly the pharmacist was offbase to suggest using these when he apparently had no clue as to the ramifications. It says right on the box to discuss any needle change with your physician. Does anyone know what the benefits of short needles are? Does anyone out there use them? Thanks, Dave

Response: