Shorter needles give ‘better results’ for the obese

Shorter needles provide “better outcomes” for obese people with diabetes, according to new research.

The study, compiled by Bergenstal et al, has dispelled the widely held belief that longer needles were the best way for overweight people to maintain healthy blood sugar levels.

Researchers have discovered that the 4mm pen needles, which are the shortest currently available, provide equivalent glycaemic control when compared to longer ones.

People with diabetes using injection therapy need to ensure that insulin is injected into the fatty area beneath the skin, known as the subcutaneous layer, in order for it to be absorbed at a predictable rate.

The results of this study are significant and effectively dispel the widely held belief that obese people with diabetes need to use longer pen needles for insulin injection therapy

Accidentally injecting into the muscle under the subcutaneous layer can accelerate the absorption of insulin, which can increase the risk of hypoglycaemia.

Statistical difference

The use of longer needles can increase the risk of intramuscular injection and it was widely thought that obese people needed longer needles in order to reach the subcutaneous layer and maintain glycaemic control.

The findings were based on the measurement of glycated hemoglobin (HbA1c) levels across a group of volunteers who used a different pen needle lengths.

In each group, two assigned pen needles made up of 4mm, 8mm and 12.7mm, were evaluated during 12 weeks each in a random order.

There was no statistical difference between the HbA1c levels of those people with diabetes in the 4mm pen needle study group and those using either 8mm or 12.7mm needles.

Dr Kenneth Strauss, European medical director at Becton Dickinson and director of the European Medical Association, said: “The results of this study are significant and effectively dispel the widely held belief that obese people with diabetes need to use longer pen needles for insulin injection therapy.

“What’s more, 4mm pen needles have been shown to cause less pain than longer needles, reduce injection anxiety, and provide an overall improved injection experience, which helps people with diabetes adhere more to an insulin injectable therapy programme and improves outcomes.

“4mm needles allow obese people with diabetes to maintain glycaemic control, without the risk of intramuscular injection, so should be the length of choice for patients, prescribers and care-givers.

“I advise people with diabetes to speak to their doctors about the length of pen needles they are currently using and I encourage healthcare workers and prescribers to recommend 4mm pen needles to their patients, regardless of their BMI.”