Most diabetics use what is called an insulin pen as part of their insulin therapy. These are about the size of a pen and allow for easy dosing of insulin units. To learn how to use the insulin pen correctly, whether it is possible to use insulin pen needles more than once, and what the risks may be, read this article.
Using and adjusting the insulin pen correctly
The desired number of insulin units can be set by turning the dosage knob. The dose is displayed in analog or digital form. Each dosing step is visible and audible, for example by a clicking sound. Correct use of the insulin pen is an important element of effective insulin therapy. Insulin is injected into the subcutaneous fatty tissue of the abdomen (rapid insulin uptake) or into the outer thighs (slow insulin uptake), but the buttocks and upper arm are also possible. When injecting, a skin fold is formed with the thumb and index finger, thus reducing the risk of injecting into the muscle. To ensure optimal distribution of the insulin in the fatty tissue, the insulin should be injected slowly and the needle should not be removed until ten seconds after the injection is complete. Another important aspect of optimal insulin injection is the correct angle of injection. If a skin fold is formed, you can inject at an angle (45 degrees) or perpendicularly (90 degrees) and choose the needle length according to the thickness of the subcutaneous fat.
What insulin pens are available?
First of all, there is a distinction between disposable pens and refillable pens. With disposable pens, the insulin ampoule is not replaceable. So after it is emptied, the pen cannot be reused. There are also fully automatic and semi-automatic insulin pens. In the case of the semi-automatic pen, a spring is tensioned when the insulin dose is set. The insulin can be injected by pressing the release button lightly. Those who do not wish to administer the injection themselves should use a fully automatic insulin pen. Here, when the release button is pressed, the needle is pierced directly into the skin and the insulin is injected that way.
How can pain be avoided during insulin injection?
To significantly reduce the discomfort of insulin injection, thinner, shorter, and sharper needles with a special lubricating film have been developed. The lubricating film provides a virtually painless injection. However, when reused, the performance and safety of the needles is compromised. Both loss of lubricant and damage to the needle tip increase inconvenience during injection.
What happens if a pen needle is used more than once?
Modern pen needles are very thin, finely ground, and coated with a lubricating film. After each use, the needle becomes duller or gets small deformations and loses its gliding ability due to wear of the gliding film. Therefore, multiple uses of the pen needle may pose various health risks to patients:
- Wear on the tip of the needle can cause minor injuries and bleeding (bruising) in addition to the actual puncture. The injections then not only become increasingly painful, but the risk of the formation of so-called lipohypertrophies also increases. These changes in the subcutaneous fatty tissue (adipose tissue growths) alter the absorption (uptake) of insulin at these sites. The result is an incalculable onset of action of insulin and thus the risk of blood sugar fluctuations.
- The pen needle is already no longer sterile after the first use. In addition, tissue residues can adhere to the pen needle. This is not only unhygienic, in addition, the risk of infection increases.
- Crystallized insulin and adhering tissue remnants can lead to clogging of the pen needle and thus to underdosing of insulin.
- Air bubbles in the insulin cartridge can continue to expand or even reform when the needle is attached, depending on the temperature. As a result, insulin drips from the needle after injection and there is a risk of inaccurate dosing due to air injection.
- Due to a repeatedly used needle, the smallest injuries are also caused. The growth of fat cells and scarring are then increasingly stimulated.Injection sites are more likely to develop thickening, harder than usual subcutaneous fat and look like small hills.
Is multiple use of pen needles unsanitary?
Factory-new insulin needles are sterile, which means absolutely germ-free. A used needle or one that has been touched directly, on the other hand, is riddled with bacteria and other germs. This is not only unhygienic, the germs can also penetrate the skin if the needle is used repeatedly and, in the worst case, cause infections. The first signs are small acne pimples and round redness in the puncture area; in the worst case, skin abscesses develop.
Can a pen needle that has been used multiple times become clogged?
If the needle is left on the insulin pen, insulin remaining in the needle can crystallize between injections and cause a blockage, making it impossible to administer the insulin during the next injection. Reuse of the pen needle may cause microscopic bending of the tip and wear of the lubricating film. This is damage that is not visible to the naked eye. When the injection needle is inserted into the skin, the damaged tip additionally causes minimal injuries that can be perceived as pain. In extreme cases, the damage to the needle tip can possibly also cause small metal fragments to splinter off and become lodged in the fatty tissue. In rare cases, the needle may even break.
Cleaning the insulin pen
Do not use cleaning agents containing alcohol to clean the insulin pen. A damp cloth is sufficient for cleaning. Do not immerse the pen in water.
