Association of Diabetes Care & Education Specialists

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Is there really a difference between needle sizes?

Jun 06, 2012

Recently on the Mayo Clinic Diabetes blog there was an interesting article about needle size and how in their research they did not find a difference between absorption of a smaller 5/16 in. (8 mm) needle and a longer 1/2 in (12 mm) needle in their overweight patients. I was always taught that for children or thinner individuals, they need the shorter needles and longer needles are more appropriate for those who have more fatty tissue around the injection site. I found this article surprising-

For many, they may not “feel” their injections or experience a lot of pain but others who are more sensitive who are using the longer needles may have more compliance from switching to a shorter and smaller needle.

In the article, they described a study they did with their patients. They found the shorter 5/16 in (8mm) needle produced similar blood glucose patterns as the longer 1/2 in (12mm) needles and without additional insulin leakage at the site. Their patients were also more satisfied and willing to do their regular injections. They now recommend the shorter needle for both their overweight and normal weight adult patients. With both needle sizes, they had their patients injecting at a 90 degree angle and holding for 10 counts before taking out.

I would like to know if other educators have noticed any difference between the needles especially in their overweight patients- Please comment below to help us learn from each other-


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  1. Oct 02, 2012

    I attended the session at AADE and found it very informative-
  2. Jul 08, 2012

    BD published a study 2-3 years ago which showed that the skin thickness for normal weight versus overweight/obese individuals was no different. At AADE in 2010, a much younger than me RD had her skin thickness checked along with me. My skin was ever-so-slightly thicker, by maybe a tenth of a millimeter---this is normal as we age---but we both could use the same needle size. I have found increased patient satisfaction and no real difference in BG values with the shorter needles.
  3. Jun 16, 2012

    BD's website has some great tool and patient materials about needle length and size. There are also slides and speaker notes.
  4. Jun 14, 2012

    We do have a certificate program for those interested in exploring a career in diabetes education. For more information, please visit our web site: -Joyce Lee AADE Communications Manager
  5. Jun 12, 2012

    Enjoyed your post! My organization, the American Society for Nutrition, is hosting a conference on food, health, and nutrition science in the Chicago area later this month. We have a limited number of free media passes available for bloggers. Please let me know if you're interested in attending the event at no cost. The program features a keynote address by Dr. Dean Ornish on Friday, June 22; additional details: Please email if you are interested in attending or have any questions.
  6. Jun 06, 2012

    We have recently seen a shift here towards using shorter needles for all patients. Recent studies have shown the efficacy of 4mm needles and my usual practice now is to use 4mm for all patients (where previously I used 8mm) though I may use an 8mm in a very obese patient. There is far less chance of the insulin not being deposited into the adipose tissue and patients are much happier at the sight of them, despite not reporting more pain with the 8mm. They are injected at a 90 degree angle and do not require to pinch up the skin. Natasha, APD, CDE (Australia).
  7. Jun 06, 2012

    Soon members who are signed up to attend AADE 2012 will receive a survey from AADE. The information will be presented in concurrent session #F05 on Friday August 3, 2012 at 0800. It is titled Eat, Pray, Love...Yourself. There are many changes in government, insurance, diabetes rates and employer expectations that impact how we practice. For this survey, we are interested in your feelings about your role as a provider of care. You provide one persons unique perspective on caring for others in your setting, in your region of the country, and in caring for the population that you serve. We are interested in your feelings as a diabetes care provider. I invite you to share your story through the survey. Please take the time to respond. Thank you.

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