Reviewed on : 28 Oct 2020

Reviewed by : Gateway Editor

Expires : 28 Oct 2022

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July 2020 Newsletter

Needles for Pre-Filled and Reusable Injector Pens for Subcutaneous Injection of Diabetes Medicines October 2020

Needle Length

The recommended needle lengths for adults are 4mm, 5mm or 6mm.

For children 4mm or 5mm needles are usually recommended.

Using shorter pen needles helps to prevent lipodystrophy and avoid unpredictable blood sugar levels.

If needle length is changed, blood sugars should be monitored.

All needles are for single use only.

Needle Brand

First-line choice:          TriCare screw-on needles (Owen Mumford Ltd) (£3.95 for 100)

Second-line choice:     BD Viva screw-on needles (BD) (£3.59 for 90)

Available in 4mm/32G, 5mm/31G, 6mm/31G sizes.

Compatible with all major brands of insulin pens and GLP-1s.

Injection Technique

Injection technique should be taught when initiating a medication and checked at each diabetic review.

The key points are:

• Use a new needle for each injection
• For insulins, discharge a 2 unit ‘air shot’ before dialling dose for injection
• (For GLP-1s, follow manufacturer’s instructions for preparing injection)
• Inject at a 90-degree angle into the skin (A lifted skin fold may be needed for children or very slim adults)
• Ensure that the full dose is injected, then leave the needle in the skin for 10 seconds before removing
• The needle should be removed from the pen immediately after use and discarded in a sharps bin
• Injection sites should be rotated as instructed by the patient’s healthcare professional
• If a patient notices any lumps at an injection site, they should seek advice from a healthcare professional

Further information and a suggested checklist can be found in the Trend guidelines:

https://trend-uk.org/wp-content/uploads/2018/11/ITM-Guideline_v9-FINAL-251018.pdf

Safe Disposal of Sharps

Patients should be educated about the safe disposal of sharps before starting injections and advice reinforced at every opportunity.

Advice should include:

• Dispose of sharps immediately after use in a designated sharps container. Do not bend or break needles before discarding them. Do not put sharps in household waste.
• Place the sharps container at eye level on a steady surface and within arm’s reach to allow for easy disposal of sharps. Close the temporary closure lid following use.
• Keep the sharps container in a safe place to avoid accidental injury to others. Once filled to the ‘fill’ line close and lock the sharps container and arrange for safe disposal.
• A sharps container should be prescribed for all patients prescribed injectable medication or lancets. Sharps containers with capacity ranging from 1 litre to 9 litre can be prescribed on FP10.
• GP practices should not accept sharps bins for disposal.

Local arrangements for sharps disposal are:

Sharpsafe devices

Safety needles and lancets may be needed in certain circumstances:

These devices are not for routine use and should only be prescribed in the circumstances described above. Under Health and Safety regulations, it is the employer’s responsibility to provide safe sharp devices for their staff.

These devices should not be prescribed for use by privately employed nurses or carers, including care home staff; safety devices should be provided by their employer.