embecta, formerly part of BD

Here’s why that matters:

Diabetes self-care goes beyond healthy eating and activities.

In a study of patients with diabetes who inject insulin, patients educated on proper injection technique (including using a new needle for every injection, rotating injection sites, and shifting to a 4mm or 5mm needle) experienced an average A1C reduction of 1% at 6 months.2†

Remind patients to check their needle supply every time they refill their insulin

Why using a new needle matters:

Needles are no longer sterile after use.3

Reuse may increase risk of injection pain and bleeding.4,5‡

Reuse has been associated with increased risk of developing lipohypertrophy, which can contribute to erratic insulin absorption, 7 times higher glycemic variability, and unexplained hypoglycemic episodes.4,6,7§

Patients who were provided an adequate supply of pen needles and proper injection technique training reported no reuse of needles2||

See how BD Nano™ 2nd Gen Pen Needles can help improve the injection experience

Consistent Injection Depth
*

13,289 patients with diabetes who inject insulin participated in an Injection Technique Questionnaire survey. 38.8% of the 2,711 patients using insulin syringes reported needle reuse. 55.8% of the 11,961 patients using pen needles reported needle reuse.

†

Based on an RCT pilot study. 116 patients with diabetes (mostly type 2 diabetes mellitus) on insulin were randomized into 3 groups to assess the change in A1C over 6 months. Groups 1 and 2 received structured injection training and group 3 was the control. Baseline A1C for all groups was similar (mean: 8.5−8.8 [±1.4−1.9%]). At 6 months, mean [95% CI] reductions in A1C from baseline were significant in groups 1 and 2 (-1.00% [-1.3 to -0.6%] and -1.00% [-1.4 to -0.7%], respectively; P<0.001 for both). The mean A1C reduction in group 3 was not significant (-0.02% [-1.2 to 1.6%]).

‡

A causal relationship has not been established. 13,289 insulin injecting patients participated in a survey. Increased injection pain and needle reuse were assessed through a questionnaire and lipohypertrophy (LH) was assessed through a questionnaire and HCP assessment using visual and palpitation method. Logistic regression analysis was used to find the association between pen needle reuse and LH (P=0.02). Pain was associated with needle reuse as higher rates of injection pain were observed the more times a needle was reused (P<0.001).

§

430 patients with diabetes who had been injecting insulin for at least 1 year were observed on their injection technique (ie, site rotation, area of injection, frequency of needle/syringe reuse) as well as the presence of lipohypertrophy (LH). 49% of patients with LH reported having episodes of glycemic variability vs 7% without LH (P<0.01). "Glycemic variability" was defined as oscillations of blood glucose values from <60 mg/dL to >250 mg/dL at least 3 times a week in an unpredictable and unexplained fashion.

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116 patients with diabetes on insulin were randomized to 3 intervention groups to assess the change from baseline in A1C at 6 months following structured injection technique training. Adequate supply is defined as receiving needles sufficient for each injection.

References: 1. Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW. Worldwide Injection Technique Questionnaire study: population parameters and injection practices. Mayo Clin Proc. 2016;91(9):1212-1223. 2. Misnikova IV, Gubkina VA, Lakeeva TS, Dreval AV. A randomized controlled trial to assess the impact of proper insulin injection technique training on glycemic control. Diabetes Ther. 2017;8(6):1309-1318. 3. Frid AH, Kreugel G, Grassi G, et al. New insulin delivery recommendations. Mayo Clin Proc. 2016; 91(9):1231-1255. 4. Subcutaneous injection guidelines for the education of persons with diabetes—2019. ADCES Practice Paper 2019. https://www.diabeteseducator.org/docs/default-source/practice/practice-documents/practice-papers/adces-subcutaneousinjection-guidelines-for-the-education-of-persons-with-diabetesfinal-4-1-20.pdf?sfvrsn=4 Accessed October 4, 2021. 5. Frid AH, Hirsch LJ, Menchior AR, Morel DR, Strauss KW. Worldwide Injection Technique Questionnaire study: injecting complications and the role of the professional. Mayo Clin Proc. 2016;91(9):1224-1230. 6. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2021;44(suppl 1):S1-S232. 7. Blanco M, Hernández MT, Strauss KW, Amaya M. Prevalence and risk factors of lipohypertrophy in insulin-injecting patients with diabetes. Diabetes Metab. 2013;39(5):445-453.