Is the reuse of needles for insulin injection systems associated with a higher risk of cutaneous complications?

Schüler, G; Pelz, Klaus; Kerp, L.

doi:10.1016/0168-8227(92)90119-c

Cited by 29 publications

(26 citation statements)

References 6 publications

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“…They did not report the occurrence of any skin or SC tissue infections, however. Similar observations have been reported by others for plastic insulin syringe use [44, 45]. …”

Section: Discussionsupporting

confidence: 91%

Indian Injection Technique Study: Population Characteristics and Injection Practices

Kalra

Mithal²,

Sahay

et al. 2017

Diabetes Ther

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IntroductionIt was estimated that 3.2 million Indians with diabetes injected insulin in 2010, but little is known about the techniques used.MethodsIn 2015 we conducted an injection technique questionnaire (ITQ) survey throughout India involving 1011 patients. Indian values were compared with those from 41 other countries participating in the ITQ, known here as rest of world (ROW).ResultsMean HbA1c was 8.6. BMI values in India were 1.5–3 units lower than in ROW depending on patient group, meaning the risk of intramuscular (IM) injections is high in India. The mean total daily dose (TDD) of insulin was lower in every category of Indian patient than in ROW, perhaps reflecting the lower BMI. Needle reuse, whether with pens or syringes, is much higher in India than ROW and so is the number of times the needle is used. The majority (56.8%) of Indian insulin users performed only 2 injections/day as opposed to ROW where 45% of patients performed at least 4 injections/day. Indian patients inject insulin in the thighs more often than patients in ROW, a site where IM injections are more risky. Many patients do not have proper access to sharps containers or have other risk factors that could lead to blood-borne pathogen spread. More than 60% of used sharps in India go into the rubbish, with nearly 12% not even having the minimum protection of a cap.DiscussionThe shortest needles are very common in India; however, the level of needle reuse is high. Multiple daily injections therapy is not as common in India as ROW. More focus needs to be given to dwell times under the skin, reconstitution of cloudy insulins, skinfolds, and safe sharps disposal.

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“…They did not report the occurrence of any skin or SC tissue infections, however. Similar observations have been reported by others for plastic insulin syringe use [44, 45]. …”

Section: Discussionsupporting

confidence: 91%

Indian Injection Technique Study: Population Characteristics and Injection Practices

Kalra

Mithal²,

Sahay

et al. 2017

Diabetes Ther

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“…Availability in the public sector is often very low, meaning that families must buy them at private outlets. Syringes are sold as single‐use, but by necessity are reused , and this is generally safe . LFAC's standard provision is only two syringes/week, but the results of the present study show that even this frequency imposes a significant cost if the family needs to purchase them.…”

Section: Discussionmentioning

confidence: 69%

Financial costs for families of children with Type 1 diabetes in lower‐income countries

et al. 2015

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“…Finally, considering the high number of injections with one needle, we do know that there is only little danger of infections, 15 but we still lack adequate information of potential tissue damage and long-term complications caused by the multiple use of one needle. We need additional investigations to further define a safe and maximum number of injections per needle.…”

Section: Siegmund Et Almentioning

confidence: 98%

Comparison of Usability and Patient Preference for Insulin Pen Needles Produced with Different Production Techniques: “Thin-Wall” Needles Compared to “Regular-Wall” Needles: An Open-Label Study

Siegmund

Blankenfeld

Schumm–Draeger

2009

Diabetes Technology & Therapeutics

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Is the reuse of needles for insulin injection systems associated with a higher risk of cutaneous complications?

Cited by 29 publications

References 6 publications

Indian Injection Technique Study: Population Characteristics and Injection Practices

Indian Injection Technique Study: Population Characteristics and Injection Practices

Financial costs for families of children with Type 1 diabetes in lower‐income countries

Comparison of Usability and Patient Preference for Insulin Pen Needles Produced with Different Production Techniques: “Thin-Wall” Needles Compared to “Regular-Wall” Needles: An Open-Label Study

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