Coping with needles

Written by: 
Monica Lalanda, an Emergency Medicine doctor. Monica is also a medical writer and illustrator

Diabetes coping with needles cartoon

Diabetes will change your life, but that doesn't necessarily mean that it has to take it over.

Most people with diabetes can enjoy full physical and emotional lives. It needs a great deal of adjustment, but knowing what to expect, understanding how things work and getting the injection technique right can make the difference between suffering from diabetes and simply living with it.

Getting to grips with diabetes

The psychological side can be easily overlooked, but coming to terms with a diagnosisThe process of determining which condition a patient may have. of type 1 (insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels.-dependant) diabetes may be as important as learning how to inject the insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels..

Type 1 diabetes is a demanding condition and, worst of all, it involves the use of needles several times a day for the rest of your life. This can fill even the toughest of people with dread, and the initial shock might evolve from disbelief to denial and sometimes to grief, all of which can really get in the way of your ability to cope in a practical sense.

It's not only those who receive a new diagnosisThe process of determining which condition a patient may have. who experience anxiety - for example, if your child has just been diagnosed with diabetes, or your existing diabetes is not responding to tablets any more, you might well be experiencing all or any of the feelings above.

If so, it can be helpful to find some external source of support to help you remain positive and focused; talking to your doctor or nurse or joining a supportive diabetes organisation can make a difference. You are not alone.

Small children and older children will need a great deal of reassurance, too; children often live with the idea that their parents are all-powerful, and a child might believe that a parent can take the diabetes away. This may cause feelings of guilt in the parents, which also needs to be addressed.

Practical tips on injections

Modern needles are tiny and they enter the skin with no more than a momentary pinprick. It helps to apply some positive thinking; the insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. injections will keep you fit and leave you able to lead a normal life. It's important to try not to think of yourself as a victim of the needles; instead, see the needles as working for you.

Choosing an insulin-giving device

There is a choice of devices available, from special insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. syringes with little needles to insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. pens (with pre-filled disposable or refillable options).

The most advanced way to receive your insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. is through an insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. pump, which calculates and injects the insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. independently; this needs fewer needle pricks. Your doctor will probably help you to decide which one is best for you.

Storing your insulin

Once opened, you can keep your insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. at room temperature for up to a month. A closed vial should stay in the fridge. Do not freeze it.

Remember, cold insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. can sting a little. If you are starting a new vial, warm it up in your hand before using it.

Withdrawing the right amount

It is vital that you get exactly the right amount. Avoiding bubbles in the syringe is crucial. A bubble takes up space, so you will inject fewer units than you think if a bubble is present.

Preparing the injection area

  • It is important not to inject through your clothes
  • If you use alcohol swabs to clean your skin, wait until the alcohol has dried up, otherwise it might sting a little; however, water and soap are just as good.

Deciding where to inject

There are four areas of your body where you can inject your insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels.:

  • Your abdomenThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs. (stomach)
  • The back area of your upper arm
  • Your thighs (avoid the inner areas)
  • Your buttocks.

insulin admin

Try to use the same area at the same time each day. For example, always have the lunch-time injection in the stomach. It is important to rotate within that area. For example, the right leg one evening and the left leg the next.

If using the abdomenThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs., leave at least one finger width in between injections. The reason for this is to avoid getting sore spots and lumps (lipohypertrophyThe build-up of fat tissue at the site of repeated insulin injections, due to the local effects of insulin.).

Different areas absorb insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. at different rates. Your stomach is the fastest absorber and the buttocks are the slowest. You can use this information to help you choose where to inject, based on the time of day or the activities you are doing.

For example, you might want to use the abdomenThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs. for your breakfast injection, then your legs for the slow-release effect of the night-time injection.

It's important to avoid injecting yourself too near the belly button (navel). The skin here is a bit tougher and the absorption may vary. Also for this reason, avoid injecting near moles and scars.

Improving your injection technique

  • Pinch a couple of inches of skin (4 to 6cm) between your thumb and two fingers, pulling the skin and fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. away. You are aiming for the fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. under the skin and not for the muscleTissue made up of cells that can contract to bring about movement.
  • Insert the needle at a 90° angle and push the plunger fast - it hurts less that way
  • Release the skin, then remove the needle.

After injecting

  • Never reuse an insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. needle; small amounts of insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. will be caught in it from previous use
  • Needles need careful disposal to avoid accidents.

Injecting a small child

Self-care is the key to the development of a child's independence and self-esteem. So as soon as the injection routine is introduced, try to encourage your child to help.

Initially this might be by having the child choose the injection site or drawing the insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. into the syringe, progressing to the child figuring out how much insulinA hormone produced by the beta cells of the pancreas that acts to lower blood glucose levels. to use and then injecting him or herself.

If you can avoid being overprotective, this helps to stop the child having a 'sickly' self-image.

It helps to regard one of your main jobs as the parent of a child with diabetes as being to supervise, encourage and foster your child's independence, to allow him or her to manage the illness.

Diabetes coping with needles cartoon 2