Jaipur, 12 Nov, 2019: India has witnessed an alarming rise in incidence of diabetes in the last two decades. The country represents 49 percent of the world’s diabetes burden with an estimated 72.9 million cases in 2017, a number expected to almost double to 134 million by 2025. Diabetes, one of the major non-communicable diseases in India, accounts for about half million deaths in a year.

Insulin therapy is often a crucial part of diabetes management. About 35 percent of people living with diabetes are currently on insulin. In people with type 1 diabetes insulin is the mainstay of treatment. However, people with type 2 who are not well controlled on oral drug therapy, diet and exercise may also need insulin injections to control the blood glucose levels and prevent long-term complications from the disease like cardiovascular disease, stroke, peripheral vascular disease, kidney disease etc. These risks can be significantly reduced through good glycaemic control, diet, exercise and taking insulin properly.

Injection technique is crucial in achieving optimal control of diabetes in patients on insulin therapy.  For optimal insulin absorption, insulin needs to be injected into the fat layer under the skin to avoid the muscle. It is also important to use a new site each time for every injection. It is also recommended not to inject into the same site repeatedly and it is recommended to change the needle with every use/injection.

“Insulin pen and syringe needles are intended for single use only, but it is known that approx. 70% of people with diabetes do re-use needles primarily due to lack of awareness and training on the correct injection practices. “Needle re-use causes blunting and bending of the needle tip, increasing pain & bleeding, dosage inaccuracy, and Lipohypertrophy. Lipo is a thickened, rubbery swelling under the skin at the patient’s usual injection sites. Lipohypertrophy can lead to poor glycaemic control, hypoglycaemia and glycaemic variability.  Studies show that the frequency of needle re-use, significantly increases the risks of developing lipo. said   Dr. Dr.SK Sharma, MD(Med.), DM(Endocrinology), Diabetes Thyroid & Endocrine Centre, Jaipur  

Bacteria is present on the needle after the injection is completed and bacterial growth increases with further re-use. Macroscopic regurgitation into the cartridges is also observed. Should any caregiver get a needle stick injury with this, it could pose a potential danger of transmission of blood borne diseases such as HIV or hepatitis. Health-care professionals should create awareness among the patients regarding the potential adverse effects of re-use and discourage this practise.

Adherence to medication is a major factor in determining treatment outcomes for patients. In India, this is particularly true in the management of chronic manageable diseases such as diabetes. It is important to understand that for the medication to be effective, it must be taken correctly and why patients must always use a new needle for every injection. Reuse of needles and incorrect injection technique can lead to serious yet avoidable consequences & complications and medication errors. Hence, for patient safety, there is a dire need of spreading awareness about avoiding the re-use of insulin needles.