Effect of Reuse of Insulin Needle on Glycaemic Control and Related Complications in Children with Type 1 Diabetes Mellitus: A Prospective Observational Study

Indian J Endocrinol Metab. 2022 Mar-Apr;26(2):167-172. doi: 10.4103/ijem.ijem_407_21. Epub 2022 Jun 6.

Abstract

Background: Children with type 1 diabetes (T1D) take multiple subcutaneous injections of insulin daily to survive. It is controversial whether the insulin needles can be reused safely or not. This study assesses the effect of the reuse versus single-use of insulin needle on glycaemic control and injection-related complications.

Methods: Nearly 121 children (<15 years) with T1D were prospectively observed for existing practice of needle reuse for first 3 months and then were asked to practice single-use for the next 3 months.

Results: It was found that 78% participants were reusing needles more than three times. After 3 months of needle reuse, 91.3% patients had lipodystrophy. Frequency of reuse positively correlated with local redness, bleeding and leakage of insulin. The patients achieving HbA1c ≤7.5% was significantly low among those reusing needles more than four times. After 3 months of single-use, no significant difference was found in mean HbA1c. However, hyperglycaemic episodes, lipodystrophy and local complications reduced significantly. There was a significant reduction in mean HbA1c among those using needles more than six times earlier.

Conclusion: Reuse of insulin needles up to six times does not affect the glycaemic control significantly. To achieve target HbA1c (<7.5%) the needle reuse should be restricted to three times only, which can also reduce injection-related local complications.

Keywords: Children; glycaemic control; insulin; lipodystrophy; needle reuse; type 1 diabetes.