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ORIGINAL ARTICLE
Year : 2011  |  Volume : 2  |  Issue : 1  |  Page : 2

The Risks of Repeated Use of Insulin Pen Needles in Patients with Diabetes Mellitus


1 Department of Endocrinology, SI M. F. Vladimirsky Moscow Regional Research Clinical Institute, Shchepkina, Moscow
2 Department of Microbiology, SI M. F. Vladimirsky Moscow Regional Research Clinical Institute, Shchepkina, Moscow

Correspondence Address:
I V Misnikova
Department of Endocrinology, SI M. F. Vladimirsky Moscow Regional Research Clinical Institute, Shchepkina, Moscow

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Source of Support: None, Conflict of Interest: None


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Repeated use of the same needle for insulin injections is a common practice. How ever, after repeated use, the needle can become significantly deformed and this can increase injection morbidity and probably, the risk of lipodystrophy at the site of insulin injection. In the literature, there is evidence that repeated use of insulin needles increases the risk of infection. The aim of our study was to assess the complications of repeated use of BD Micro-Fine Plus insulin pen needles. The parameters measured were the frequency and the nature of contamination of needles with bacterial microflora, the intensity of pain and the presence of local reaction at the site of insulin injection. This was a blinded, randomized study. Forty five hospitalized patients with diabetes mellitus type 1 and 2; over 18 years of ages on a regimen of three injections of short -acting insulin a day and who gave informed consent , were included in the study. The patients were randomized into 3 groups with 15 patients in each group. The first group used their needle once only, the second group used a single needle for 4 days (12 injections), and the third group used a single needle for 7 days (21 injections). Change of needles was carried out by the medical staff. The duration of observation for all groups was 7 days. After use, microbiologic washouts were obtained from needles for aerobic and anaerobic flora and fungi. The intensity of pain after injection was estimated , using the Visual-Analogue Scale (VAS) on day 1, 4 and 7 of the study. The presence of local reaction at insulin injection site was determined by a doctor on days 1, 4 and 7 of the study. Differences were considered statistically significant at p <0.05 (95 % level of significance). Growth of microbe flora (Staphylococcus epidermidis - (Hly +) was found in 26,6 % of the patients, who used a needle once only. The maximum number of needles contaminated by microflora was found in the 3rd group (33.3 %) (Staphylococcus epidermidis - (Hly +) and Gram+ bacilli. The intensity of pain was significantly higher in the 2nd group than in 1st one (p=0,045) on the fourt h day of study, and in the 3rd group pain was considerably more intense than in 1st group (?=0. 03) on day 7 of the study. Hyperemic foci at injection sites on day 4 and 7 of the study were found only in the 2nd and 3d groups (13.3 and 26,6 %, correspondingly). After a single use microbe contamination can be detected on insulin needles. Repeated use of needles amplifies the risk of needle contamination. Patients using insulin needles several times have more pain at injection site.


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