Insulin Pen Needle Reuse: Risks, Safety Guidelines & Proper Usage | Diabetes Injection Tips

Why can't insulin pen needles be reused? 

Insulin pen needles are not recommended for reuse as repeated use can lead to needle tip dulling, increasing pain during injection, compromising dose accuracy, potentially causing subcutaneous fat hypertrophy, and affecting insulin absorption.

Blunted Needle Tips: With repeated use, needle tips can lose their sharpness, resulting in increased discomfort during injection and potentially damaging skin or subcutaneous tissue.

Reduced Dosing Accuracy: Wear and tear or blockages in the needle can interfere with the precise delivery of insulin, affecting blood glucose control, particularly crucial for diabetics who rely on accurate dosing.

Subcutaneous Fat Proliferation: Frequent injections at the same site can stimulate tissue, leading to the formation of fatty lumps (lipohypertrophy), which not only cause more pain during injection but also impair insulin absorption uniformity.

Increased Infection Risk: Used needles may harbor bacteria, and reusing them heightens the risk of local or systemic infections, including severe complications like bloodstream infections.

Risk of Needle Breakage: Multiple uses can weaken the needle structure, raising the likelihood of needle breakage, a painful event that may necessitate medical intervention for removal.

Compromised Insulin Activity: Improper needle sanitization methods, such as using iodine tincture, can potentially impact insulin molecule integrity, reducing its biological effectiveness and thereby undermining treatment efficacy.

What are the potential risks of reusing insulin pen needles? 

Potential risks include skin infections, needle clogging, inaccurate dosing, and needle breakage or retention beneath the skin.

1. Local Infection: Reused needles can introduce bacteria into the injection site, increasing the risk of infection.

2. Injection Site Pain: As needles become dull with reuse, they can cause more pain upon injection.

3. Bleeding and Bruising: Dull needles are more likely to cause bleeding and bruising at the injection site.

4. Skin Induration and Lipodystrophy: Repeated injections in the same area can lead to hardening of the skin and the development of fat pads, which can affect the absorption of insulin.

5. Reduced Dosage Accuracy: The needle's precision may be compromised with reuse, leading to inaccurate insulin dosing.

6. Increased Trauma to Tissue: Reused needles can cause more tissue damage, which may exacerbate the aforementioned issues.

7. Potential for Needle Breakage: With wear and tear, the structural integrity of the needle can weaken, increasing the risk of breakage during injection.

How should used insulin pens needles be properly handled? 

Used needles should be immediately removed and discarded in an appropriate container to prevent contamination and accidental injury.

1. Do Not Reuse: Never recap or bend the needle after use as this can lead to accidental pricks.

2. Disposal Container: Dispose of the used needle in a puncture-resistant container that is specifically designed for sharps disposal.

3. Immediate Removal: Remove the needle from the insulin pens as soon as the injection is complete to avoid any leakage or spillage.

4. Avoid Touching: Do not touch the needle or the sharp part of the needle while disposing of it.

5. Secure the Container: Make sure the sharps container is tightly sealed after each use to prevent leaks or accidental needle exposure.

6. Label the Container: Clearly label the sharps container with a biohazard symbol or a warning that it contains used needles.

7. Store Safely: Keep the sharps container in a safe place, out of reach of children and pets.

8. Dispose Correctly: Once the sharps container is full, follow your local regulations for the proper disposal of medical sharps. This may involve taking the container to a healthcare facility, pharmacy, or a designated hazardous waste disposal site.

9. Never Dispose in Regular Trash: Do not throw used needles in the regular garbage to avoid the risk to sanitation workers and the environment.

10. Clean Hands: After handling a used needle, clean your hands with soap and water.

11. Emergency Precautions: In case of an accidental needlestick, clean the area immediately with soap and water, apply an antiseptic, and seek medical advice if necessary.

Is there a recommended standard for the number of times an insulin pens needle can be used? 

It is advised that each needle is for single-use only to ensure the safety and efficacy of injections.

1. Dispose of Used Needles Promptly: Do not reuse or recap the needle, as this can lead to needlestick injuries and contamination.

2. Use a Sharps Container: Place the used needle into a puncture-resistant sharps container, which is specifically designed to hold used needles safely.

3. Do Not Remove the Needle from the Pen: If your insulin pens has a needle attached, do not unscrew or remove the needle before disposal. This reduces the risk of accidental needlestick injuries.

4. Secure the Cap: If your sharps container has a cap, make sure it is secured tightly after placing the used needle inside.

5. Label the Container: Clearly label the sharps container with a biohazard label or a warning that it contains sharp objects.

6. Store Safely: Keep the sharps container in a safe place, out of reach of children and pets.

7. Dispose of Properly: Once the sharps container is full, follow your local guidelines for the proper disposal of medical sharps. This may involve taking the container to a healthcare facility, pharmacy, or hazardous waste disposal site.

8. Never Dispose of Needles in Regular Trash: Do not throw used needles in the regular garbage, as this poses a risk to sanitation workers and the environment.

9. Clean Hands: After handling a used needle, clean your hands thoroughly with soap and water.

10. Emergency Precautions: In case of an accidental needlestick, clean the area immediately with soap and water, apply an antiseptic, and seek medical advice if necessary.

Why do hospitals sometimes reuse insulin pens? 

This practice, though not advisable, might occur due to cost considerations or lack of awareness about the risks involved. However, it increases the risk of cross-infection and potential exposure to viruses like HIV, hepatitis B, or C.

1. Cross-Infection: Reusing needles can introduce pathogens from one individual to another, or back into the same individual, if the needle has come into contact with contaminated blood.

2. Increased Risk of Blood-Borne Viruses: The risk of contracting blood-borne viruses such as HIV (Human Immunodeficiency Virus), HBV (Hepatitis B Virus), and HCV (Hepatitis C Virus) is heightened when needles are shared or reused.

3. Local Infections: Besides systemic infections, reused needles can also cause local skin infections at the injection site.

4. Transmission of Other Diseases: In addition to viral infections, there is also a risk of transmitting other blood-borne diseases through the reuse of needles.

5. Reduced Injection Site Healing: Infections can slow down the healing process of the injection site, leading to prolonged discomfort and potential scarring.

6. Immunological Response: The body's immune response to fight off infections can divert resources away from managing diabetes effectively.

7. Psychological Impact: The fear of infection can lead to anxiety and stress, which can further complicate diabetes management.

8. Legal and Ethical Concerns: In many places, the reuse of medical needles is not only medically unsound but also legally and ethically questionable.

9. Public Health Risk: The reuse of needles contributes to the spread of infectious diseases, posing a public health risk.                                                                                                                                                                    However, hospitals reuse insulin pens. In the hospital, medical staff prepare separate insulin pens for each patient or use reusable insulin pens, but replace the needle with a new one immediately after each injection, and properly dispose of the used needle and place it away. in dedicated sharps containers to maintain the highest standards of patient safety and hygiene. insulin pens are personal items and are only used by designated persons. The needle should be replaced with a new one each time to ensure hygiene and safety.

What is the correct method for using an insulin pens? 

Proper use includes cleansing the skin, correctly installing the cartridge, using a new needle for each injection, holding the needle in place for 10 seconds after injection before removal, among other steps.

1. Wash Your Hands: Before handling the insulin pens or vial, make sure to wash your hands thoroughly with soap and water.

2. Check the Insulin: Ensure that the insulin is the correct type and not expired. The insulin should be clear and free of clumps or color changes.

3. Prepare the insulin pens: If you are using a reusable pen, install a new needle. For a disposable pen, remove the protective cap from the needle.

4. Disinfect the Skin: Clean the injection site on your skin with an alcohol swab and let it air dry.

5. Install the Cartridge: If using a reusable pen, insert a new insulin cartridge and remove the protective cap from the needle.

6. Prime the Pen: If necessary, prime the pen by pushing the plunger until a small drop of insulin appears at the needle tip, ensuring there are no air bubbles in the needle.

7. Select the Dosage: Dial the desired dose on the pen, following the manufacturer's instructions.

8. Inject the Insulin: Insert the needle at a 90-degree angle to the skin (or at a 45-degree angle if you have a lot of subcutaneous fat). Press the plunger to inject the insulin.

9. Needle Stay: After the injection, keep the needle in place for a count of 10 seconds to ensure all the insulin has been delivered.

10. Dispose of the Needle: Remove the needle carefully to avoid spilling any insulin. If using a reusable pen, unscrew the needle and discard it in a sharps container.

11. Store the Pen: Store the insulin pens with the needle removed to prevent leakage and contamination.

12. Record Your Dose: Keep a record of the dose, time, and injection site in your diabetes management log.

13. Rotate Injection Sites: Rotate your injection sites to prevent lipodystrophy and ensure even absorption of insulin.

14. Safe Disposal: Use a sharps container for the safe disposal of used needles and follow local guidelines for the disposal of medical waste.

How should insulin pens needles be selected? 

Needle selection should be based on the patient’s body type and injection site to minimize the risk of injecting into muscle tissue.

1. Assess Body Habitus: Consider the patient's body weight and the amount of subcutaneous fat when selecting a needle length.

2. Injection Sites: Common injection sites include the abdomen, thighs, buttocks, and arms. The depth of subcutaneous tissue varies by site.

3. Needle Length Options: Insulin pen needles are available in various lengths, typically ranging from 4mm to 12mm or more.

4. Shorter Needles: For most adults and children, shorter needles (4mm to 6mm) are often sufficient and can help avoid intramuscular injection.

5. Skin Pinching: For very short needles (e.g., 4mm or 5mm), it is usually not necessary to pinch the skin before injecting, especially in non-abdominal sites.

6. Pinch Technique: If using a longer needle (8mm or longer), especially in thinner individuals, pinching the skin before injection can help ensure the needle reaches the subcutaneous tissue.

7. Obese Patients: Thicker subcutaneous fat layers in obese patients may necessitate the use of longer needles to reach the subcutaneous tissue.

8. Children and Teens: In general, shorter needles are recommended for children and teens, but the specific needle length should still be based on individual body habitus.

9. Education and Training: Patients should be educated on the correct injection technique, including needle selection, by healthcare professionals.

10. Rotate Injection Sites: Regularly rotate injection sites to prevent lipodystrophy and ensure even absorption of insulin.

11. Z-track Injection: For longer needles or thinner patients, a Z-track technique can help reduce the risk of injecting into the muscle layer.

12. Supervise Injections: Healthcare providers should supervise patients' first few injections to ensure correct needle length and injection technique.

How should injection sites be chosen and rotated when using an insulin pens? 

Sites with ample subcutaneous fat, such as the abdomen, outer thigh, or upper arm, should be chosen, and injection sites should be rotated regularly to reduce tissue damage.

1. Choose Subcutaneous Tissue-Rich Areas: Opt for sites with a good layer of subcutaneous fat, such as the abdomen (excluding the navel area), thighs, and upper arms.

2. Avoid Muscle Tissue: Stay away from areas where the needle could reach muscle tissue, which can hasten insulin absorption.

3. Rotate Sites Regularly: Systematically rotate your injection sites to prevent localized tissue damage. This can be done by dividing the abdomen into quadrants and alternating between them, as well as rotating between the thighs and arms.

4. Rotate Within a Site: Even within a chosen site, like the abdomen, rotate the specific injection spot to avoid repeated trauma to the same tissue.

5. Use a Rotation Schedule: Implement a structured rotation schedule to ensure that you are not reusing a site too frequently.

6. Avoid Same Spot for Consecutive Days: Do not inject insulin into the same spot two days in a row.

7. Watch for Lipohypertrophy: These are areas of thickened, rubbery skin that can develop from frequent injections. If you notice these, adjust your injection sites accordingly.

8. Educate on Technique: Patients should be educated on the correct injection technique, including site selection and rotation, by healthcare professionals.

9. Injection Depth: For most adults, a needle length of 4mm to 6mm is usually sufficient and can be injected without skin pinching.

10. Consider Body Habitus: The choice of needle length and site may vary depending on the individual's body habitus and the depth of subcutaneous fat.

11. Post-Injection Care: After injecting, keep the needle in the skin for an additional 10 seconds to ensure all the insulin is delivered.

12. Record Keeping: Keep a record of your injection sites and times to help with rotation and to monitor for any signs of skin changes.

What are the storage conditions for insulin pens? 

Opened insulin pens can be stored at room temperature, while unopened ones should be refrigerated, avoiding freezing.

1. Room Temperature: insulin pens that are currently being used can be stored at room temperature, typically between 15°C to 30°C (59°F to 86°F), away from direct heat or sunlight.

2. Avoid Refrigeration: Once opened, insulin pens should not be stored in the refrigerator, as temperature fluctuations can affect the insulin.

3. Keep Pen Attached: If you're using a reusable pen, keep the pen attached to the cartridge when not in use.

4. Protect from Light: Insulin should be protected from direct light, so it's a good idea to store the pen in a cool, dark place when not in use.

For Unopened insulin pens and Cartridges:

1. Refrigerator Storage: Unopened insulin pens and cartridges should be stored in the refrigerator, ideally between 2°C to 8°C (36°F to 46°F).

2. Do Not Freeze: Ensure that the insulin is not subjected to freezing temperatures, as this can damage its molecular structure and render it ineffective.

3. Keep Original Packaging: It's best to keep unopened insulin in its original packaging to protect it from light.

4. Avoid Humidity: Try to store insulin in a part of the refrigerator that doesn't experience high humidity.

5. Expiration Dates: Check the expiration date on the insulin packaging to ensure it is still safe to use.

When traveling or away from home, it's important to keep insulin pens and cartridges with you and not in checked luggage, as fluctuations in temperature and pressure can affect the insulin's efficacy. If you're on an airplane, carry the insulin in your carry-on bag and keep it with you at all times.

Does reusing insulin pens needles lead to poor blood sugar control? 

Yes, needle reuse can result in inaccurate dosing, impacting blood glucose control.

Needle Dulling: Reused needles can become blunted, increasing pain during injection and potentially leading to incorrect injection depth, either too shallow or too deep, which can impair insulin absorption.

Inaccurate Dosing: Obstruction or partial blockage of the needle from residue can hinder the proper discharge of insulin, resulting in dosing inaccuracies.

Reduced Insulin Potency: Repeated use of needles may cause insulin crystals to form within the needle, potentially decreasing insulin potency.

Increased Infection Risk: Used needles can harbor bacteria, elevating the risk of infection at the injection site.

Tissue Damage: Repeated use of the same needle can lead to tissue injury at the injection site, manifesting as bleeding, bruising, and discomfort.

Lipohypertrophy: Prolonged injection in the same area, particularly into muscle tissue, can lead to subcutaneous fat accumulation, impacting insulin absorption.

Risk of Needle Breakage: Reused needles are more susceptible to breaking, especially when they become dulled or damaged.

Reduced Patient Adherence: The pain and inconvenience associated with reusing needles may discourage patients from adhering to their injection regimen, negatively affecting treatment compliance.

After how many uses should an insulin pens needle be replaced?

According to the Chinese Diabetes Medication Injection Technique Guidelines (2016 Edition) and most medical experts, insulin pens needles should be used once and then immediately replaced.

As we delve deeper into the treatment and care of patients with diabetes, we must emphasize the importance of following professional medical guidelines and expert advice. According to the clear guidance of the "China Diabetes Drug Injection Technical Guidelines (2016 Edition)" and combined with the professional opinions of many medical experts, we strongly recommend that when diabetic patients use insulin pens for injection, the needle should be used once and should be used after each use. Replace immediately.

This recommendation is not groundless, but is based on in-depth consideration of patient health and safety. First of all, disposable needles can significantly reduce the risk of infection at the injection site, avoid the spread of bacteria or viruses, and protect the patient's skin health. Secondly, the new needle is sharper, which can ensure the accuracy and dose control of insulin injection, thereby improving the effect of blood sugar management. In addition, the new needle reduces pain during injections and improves patient comfort.

Furthermore, reusing needles may cause them to become blunt or bent, which not only affects the insulin injection effect, but may also cause unnecessary damage to the patient's skin. At the same time, long-term use of the same needle may also cause subcutaneous fat hyperplasia, affecting the absorption and utilization of insulin, further aggravating the condition.

Therefore, for the health and well-being of patients, we call on diabetic patients to strictly follow the "China Diabetes Drug Injection Technical Guidelines (2016 Edition)" and the recommendations of medical experts. When using insulin pens for injections, be sure to ensure that the needle is disposable. And replace the needle with a new one immediately after each injection. This is not only responsible for your own health, but also caring for your family and society.

What details should be noted when injecting with an insulin pens?

Key points include washing hands before injection, verifying insulin type and dosage, properly installing the pen cartridge, cleaning and disinfecting the injection site, determining whether to pinch the skin based on needle length, and leaving the needle in place for 10 seconds post-injection before removal.

1. Hand washing prior to injection: This fundamental hygiene practice reduces the risk of infection at the injection site.
2. Verifying insulin type and dosage: Ensuring the correct insulin type is being used and the prescribed dose is set accurately avoids medication errors.
3. Correct installation of insulin pen cartridges: Following the product instructions to install cartridges correctly, securing them in place, and mixing insulin if necessary.
4. Inspecting and disinfecting the injection site: Choosing an appropriate injection site (such as the abdomen, thigh, buttock, or upper arm), and thoroughly cleansing the skin with 75% alcohol swabs, allowing it to dry.
5. Pinching the skin, if needed: Depending on the individual's body type and injection site, pinching the skin may be required to avoid injecting into muscle, especially for thinner individuals or when injecting in the arms or thighs.
6. Primining the pen: After inserting a new cartridge or if the pen has been idle, prime the pen by setting it to 1 unit and gently pressing the injection button until a drop of insulin appears at the needle tip.
7. Injection: Inserting the needle swiftly and vertically or at the recommended angle for the individual's body and site, then smoothly depressing the injection button to administer the set dose.
8. Post-injection needle pause: Keeping the needle in place for approximately 10 seconds following the injection, then withdrawing it steadily along the insertion path to prevent insulin leakage or needle hooking.
9. Site care and needle disposal: Gently applying pressure with a dry cotton ball over the injection site without rubbing, and immediately discarding the used needle safely into a sharps container, never reusing or casually discarding it.