Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes.

Abstract

OBJECTIVE: To study whether 8-mm needles can reduce the frequency of intramuscular injections in diabetic children. RESEARCH DESIGN AND METHODS: We conducted a prospective crossover study in 50 children whose BMI was < or = 60th percentile to compare two lengths of needles (12.7 and 8 mm) regarding the occurrence of intramuscular injections as assessed by ultrasonography. RESULTS: The frequency of intramuscular injections was 86% with the 12.7-mm needles and 38% with the 8-mm needles. The frequency of intramuscular injections was significantly reduced when using the 8-mm needles in the arms (P < 0.01) and thighs (P < 0.001). The efficiency of 8-mm needles, as defined by an intramuscular injection with a 12.7-mm needle and a subcutaneous injection with an 8-mm needle, was found for half of the children who injected in the arm and for two-thirds of the children who injected in the thigh. The subcutaneous tissue (SQT) thickness measured by ultrasonography with a skinfold was significantly higher (9.8 +/- 2.2 mm) in the group in which the 8-mm needles were efficient than in the group in which they were not efficient (6.8 +/- 2.1 mm, P < 0.0001). The efficiency of the 8-mm needle was not related to age, sex, BMI, percentile of BMI, injection device, or injection site. The sensibility and specificity of SQT thickness in predicting the efficiency of the 8-mm needles were both 79%. CONCLUSIONS: Needles that are 8 mm long significantly reduce the risk of intramuscular insulin injection in slim or normal-weight (BMI < or = 60th percentile) diabetic children and adolescents.