Injecting & Lancing, FAQ

This is not a tutorial on injecting or lancing. There are plenty of videos on the process if you search YouTube. This is to answer some common questions from friends, family, and those recently diagnosed with diabetes.

Does the needle hurt?

Lancet needles: Using a good lancing device set at the lowest possible depth setting will not hurt. At worst, it will feel like a light pinch. At best, you will not feel it at all. I use the Accu-Chek Multiclix at 1.5 setting. It draws enough of a blood droplet for my meter. My skin is not that soft either, you can try a few different settings to got comfortable with the depth that suits you.
Insulin pen needles: I resisted my endocrinologist’s advice to start insulin for at least six month due to concerns that injecting would be a complex and painful process. I had preconceived notions on needles. I wish I had started when he initially discussed this with me. Injecting is actually less painful than the lancing needles. I use BD Nano 4mm needles and inject in my abdomen. I follow the recommendations by the insulin pen manufacturers and watched several videos to get the technique right. It is pretty simple, fold the abdomen skin a little bit, prime the insulin pen, and insert quickly at a 90 degree angle. I hardly feel the needle going in.

Can I reuse needles?

I attend the Diabetes Information Center in my home town. The Center is run by the local hospital. They have free seminars on nutrition and one-on-one consultations that include a dietician and registered nurse. I was told that re-using needles was not recommended. They suggested that the needles can become dulled even from just one use. In practice, however, I have reused the same lancet needle for up to one month, using it at least 6 to 8 times daily. On average, I get at least two weeks from a lancet needle. When you first start using a lancet needle, follow the recommendations until you get comfortable with how the lancing device feels. As you get more comfortable with this, try reusing the same needle a few times ... you should be able to "feel" when the needle needs to be replaced based on a slightly more pronounced pinched feeling. With insulin pen needles, I reuse them 5-6 times, also letting the pinched feeling guide my decision on replacing the needle.

If I start insulin, can I get off of it some day?

Oh, absolutely. If your doctor is recommending insulin, do not resist. Her/his decision could be for a variety of reasons, including giving your pancreas a rest so that it can better heal (or heal quicker). Insulin is not addictive and your pancreas will not atrophy because you are replacing its insulin producing function.

What is the best way to avoid a callus at the injection site?

There are potentially two problems with injection sites. A callus would occur if you use a lancing device on the same finger for many months at a time. It is best to alternate fingers, and lance on the end of the finger near the side where it is less painful. Also, change hands. If you alternate fingers, and alternate to each side of your fingers, that is a total of 20 days before you get back to the same finger/side. The second problem is injecting insulin in the same area. If you inject in or near the same area, you can end up with a hard lumps or pockets of fat at the same injection site. There are so many large areas that you can use, alternating is really not that difficult. I inject five to six times a day. I alternate the long-term insulin injection using my navel as the center point. On odd-days, I inject on the left, on even-days, I inject on the right. And vice-versa with the meal time injections, even days on left, odd days on right. The trick is not use the same spot all the time, especially with the meal time injections.

Where can I find someone to talk to about my diabetes (or pancreatitis)?

In Ontario Canada where I live, every hospital has a "Diabetes Information Center" that is located within the hospital or close by. This service is free to local residents. They offer a considerable number of seminars including nutrition, meal planning, exercising, smoke cessation, ... anything related to diabetes. You also have the option for one-on-one consultations where they will monitor your health, particularly your blood sugar levels and signs of neuropathy. Your regular doctor or endocrinologist can also point you to resources available in your local community that may be offered by your local health unit, hospital, or other outreach organization. You will also find quite a few diabetes related forums, just do a Google search on "diabetes forum" to get a list. There are far fewer resources for pancreatitis. I know only of one active pancreatitis forum based in the UK. I participated for a few weeks. There are a few participants from outside the UK, but overall, I found the discussions more related to the UK medical environment. The difference in availability of prescriptions medicines, over the counter supplements, health benefits, etc. were substantial enough that I opted out of participating. I continue my search for pancreatitis support more local to where I live. I am putting together a resource page that you can view. It is fairly limited right now. if you have a listing you want included on that page, contact me.

Update: I have been actively searching for pancreatitis support in my home town. I have tried calling the region main Health Network, the local hospital, and the Diabetes Information Center. The Diabetes Information Center offered to take on the support with nutritional information with a dietician assigned as well as an RN for support. This is terrific, the same group to support both my T2 diabetes and my Idiopathic Chronic Pancreatitis – and, local (within five minutes of where I live).

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