- With Mayo Clinic diabetes educators
Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
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Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Nancy Klobassa Davidson and Peggy Moreland
Nancy Klobassa Davidson, R.N., B.S.N, C.D.E
Nancy Klobassa Davidson is a registered nurse who has worked in diabetes education for 17 years. She is a certified diabetes educator (C.D.E.) and is currently in graduate school working on a Master of Science in nursing (M.S.N.) and health care education.Nancy works with adults who have type 1, type 2 and other forms of diabetes. Nancy is coordinator of the Diabetes Unit's intensive insulin therapy program within the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn. Nancy has worked extensively with insulin pump therapy and continuous interstitial glucose sensing.
Peggy Moreland, R.N., M.S.N.
Peggy Moreland is a certified diabetes educator (C.D.E.) in the Division of Endocrinology, Diabetes, Metabolism, & Nutrition at Mayo Clinic in Rochester, Minn.Peggy graduated with a Master of Science in Nursing and Health Care Education from the University of Phoenix and is a member of the American Association of Diabetes Educators and the American Diabetes Association. A certified diabetes educator (C.D.E.), Peggy enjoys working with patients to set and achieve diabetes self-management goals.
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Living with diabetes blog
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April 5, 2012
Insulin injections: Does needle length matter?
By Nancy Klobassa Davidson, R.N., and Peggy Moreland, R.N.
Most of us aren't crazy about needles, and many people just plain freak out around needles. Recently, I had a patient tell me, "I've had diabetes for 19 years, and I still have trouble with the needles and insulin injections — I even have a couple of tattoos!"
In years past, we diabetes educators at Mayo Clinic in Rochester, Minn., promoted the longer, 1/2 in. (12 mm) insulin injection needles for our overweight patients. But we've recently adjusted our recommendations after doing a literature search for peer-reviewed studies and publications on needle length published last year. Our questions as we did this search were:
- Should the choice of needle length depend on skin thickness or fatty tissue thickness?
- Will a shorter needle length increase a person's satisfaction and compliance?
What we found is that the shorter, less intimidating, needles of 5/16 in. (8 mm) provided the same blood glucose control as the longer, 1/2 in. (12 mm) needles, with no increase in insulin leakage at the site. Those studied also reported less pain and increased satisfaction.
We now recommend that overweight or normal weight adult individuals use the shorter 5/16 in. (8 mm) insulin syringe needle. However, technique is important when injecting insulin and can make a big difference in the absorption and dosing. The preferred injection site is the abdomen, although other sites can be used. And a person should inject straight in at a 90-degree angle, holding the needle in place for a count of 10 before removing. Very lean people using 5/16 in. (8 mm) needles may need to pinch the skin and inject into a skin fold to prevent the possibility of injecting into muscle. Individuals already using the 1/2 in. (12 mm) needles should also use a skin fold.
Regards,
Nancy
4 comments posted
March 12, 2013 8:34 p.m.
In an article posted 5-6 months prior to this one, the author recommends 4mm-6mm, 31-32 gauge syringes for everyone. She cites a study that found everyone's skin thickness is about the same, whether thin or obese. The author cites a second study verifying the effectiveness of 4mm-5mm syringes: http://www.diabeteshealth.com/read/2011/11/06
/7341/choosing-a-needle-to-inject-insulin-wha ts-the-difference/ - eric
May 9, 2012 3:18 p.m.
Wendy, Try the 4 mm: don't pinch and go straight in and if it is not affecting your blood glucose you can stay with the shorter needle.
- Nancy and Peggy
May 1, 2012 11:46 a.m.
My personal pharmacist talked me into longer needles and I use 8 mm. I am obese, especially in the abdomen. But my dietitian and the pharmacist at work are suggesting I switch to 4 mm.
- Wendy
April 11, 2012 3:28 p.m.
I use a mini needle (not micro) and have found that pinching up really helps, both on my stomach and on my thigh. It's difficult to remember to wait those ten seconds after the injection when one is in a hurry. Thanks for the reminder.
- Meg
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