Inside Diabetes Guide to Injection technique by Desang Diabetes media supported by BD (Becton Dickin

22

REFERENCES

If I have a high BMI do I need to

use a longer pen needle?

Do I need to prime or complete an

airshot, every time I inject, or just

with a new pen?

What is injection rotation? What

are injecting sites?

On average, any individual's skin

thickness is 1.9mm to 2.4mm. So,

a needle only needs to be able to

reach the fatty layer. A 4mm needle

is considered the safest for adults

and children - regardless of age, sex,

ethnicity or body weight.

Pens should be primed before

each injection to ensure free and

unobstructed flow. Manufacturer's

instructions should be followed.

Priming entails seeing at least a

drop of insulin at the tip of the

needle. Once free flow is verified,

then dial the desired dose and

inject.

If I have lumps in places where I

inject will these go away if I start

moving around my injection sites?

In some cases, lipos/fatty lumps and

bumps can disappear with good

injection technique. They can also

shrink in size.

Inject at least a finger-width away

from your last injection. A single

injection site should not be used

more than once every four weeks.

This means the exact spot of

injection, not the area itself. The

abdomen area can be split into four

quadrants. Within a quadrant on

the abdomen there are multiple

injection sites. These individual sites

should not be used more than once

every four weeks.

Do you hold the plunger down

until you release it (i.e take it out

of the skin)?

Why should I change my needle?

/ How oft en should I change my

needle?

What is a sharps bin?

Do I need a skin tuck to inject into?

For the majority of individuals with

a 4mm needle, a skin lift won't be

needed. But for some it may be

advisable if they are very lean.

Inject the insulin slowly

ensuring that the plunger (syringe)

or thumb button (pen) has been

fully depressed and all insulin has

been injected. With pens it is

advised to count to 10 after the

button has been fully depressed

before withdrawing the needle.

Insulin pen needles are sterile,

designed to be used only once for

the single injection and then

discarded. After each use microbe

contamination of the needle has

been shown to occur, using a new

needle each time helps to avoid this.

There is also increased risk of skin

inflammation with reuse of needles.

A sharps bin is a container that can

be filled with used medical needles

and all categories of sharps waste,

before being disposed of safely.

1. Frid AH, Kreguel G, Grassi G et al.

Worldwide Injection Technique

Questionnaire Study: Population

Parameters and Injection Practices.

Mayo Clin Proc. 2016;91(9):1231-1255

2. Gibney MA, Arce CH, Byron KJ et

al. Skin and subcutaneous adipose

layer thickness in adults with diabetes

at sites used for insulin injections:

implications for needle length recommendations.

Curr Med Res Opin.

2010;26(6):1519-1530

3. Smith M., Clapham L. & Strauss K. UK

lipohypertrophy interventional study.

Diabetes Research and Clinical Practice.

126 (2017) 248-253

4. FIT UK: The Forum for Injection

Technique. Injection technique

recommendations, 4th Edition Oct 2016

Images supplied by BD from its online BD and Me learning modules.

Index

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