Yup - my son gets a fresh pen needle and fresh lancent every time. I have not changed my lancet for quite some time and re-use pen needles.
But… I do use alcohol for pods and dexcom sensors because they stay in for a while.
I have had one skin infection in my life and it had nothing to do with diabetes. I was at a work site in the rocky mountains and was just packing up to leave. There was a cuticle stick out of my thumb and I just yanked it out. I drove to the airport and flew home and by the next day had soreneas around the nail that tuened into an infection. There was really no blood or open wound.
Anywhoo… GROUP A STREPTOCOCCUS said the lab report and some antibiotics knocked it off. Now I have some parinoia about open wounds and infection, but definitely not the parinoia of my grandparents who grew up and raised their kids without access to modern antiboitics.
we usually try to have Samson take a bath, put the unisolve on so the old site comes off, clean it all off, and then use wipes. Infection is a scary possibility!
I think the risk is small but not negligible.
I found one study showing a small risk of infection, but it’s not clear to me that the infection traveled beyond the level of the skin:
I think the odds of infection are related to the depth of the cut and the type of germs likely to be harbored on the skin, etc… I know, for instance, that getting an infection from a cat scratch is extremely likely relative to the odds of getting an infection from a scraped knee.
My guess is that alcohol swabbing, of the type we do before pump site changes, modestly decreases the risk of skin infection – but there’s also chance it could also increase the risk if it dries out the skin and removes some of the natural protective mechanisms associated with the skin. I recently read a (mouse) study suggesting that allergies could be partly tied to the frequent use of baby wipes. I dont know if any of these natural barriers also prevent infection, and in any case with a site you’re actually puncturing the skin, but it’s certainly a possibility I’d be curious to learn more about. Until that time of course, I’d continue to use alcohol wipes with every site change.
I got a skin infection that was traveling into the bloodstream… from a mosquito bite that I scratched too much! so it really can happen with any kind of surface issue and it seemed like a total one-off. I was just unlucky.
I realize this is an old-ish thread but I found it when I was searching for information about alcohol wipes. I have had T1 for going on 23 years. I change my lancet every few months and I never swab before I put in a new pump set or use a syringe (depending on which mode I’m in). I DO use them before CGM changes because it definitely helps the adhesive stick better.
That being said, I talked with my pharmacist friend and she said that if you are using a bottle of insulin and don’t wipe it off every time, and you are reusing syringes, it can introduce bacteria to the vial and render it less effective.
My question is, if I’m using a PEN (vs syringes, which I currently do), and I leave a pen needle on it without ever wiping it down, will that possibly render the insulin less effective?? I’m not sure how long it will take me to use a pen of Fiasp, but I did pitch the vial because I didn’t use it fast enough.
The concern I’ve heard about leaving a pen needle on an insulin pen is that it can introduce more air into pen than ideal…which might cause a problem? I tend to use one pen needle a day for two injections…so I don’t claim to have perfect techniques but I haven’t noticed adverse effects, either.
I’ll watch this thread bc I’m curious to see how the veterans weigh in on it.
Thanks for your feedback. I am taking small doses at a time (usually less than 5 units) so am not sure how much of a difference it makes. I also don’t like wasting insulin priming the needle, and I’m lazy, so prefer to leave the needle on.
For my Victoza, I leave the same needle on for the whole 10 days and use it 10 times. No issues there, but it’s not precise like short-acting insulin. (I can miss a day and be fine.)
I know people worry about this stuff. And you will never do harm by always wiping the pen tip and using a new needle every time, and following all the rules.
But on the other hand, I could probably challenge you to render an insulin vial or pen container of insulin useless with only the lack of wipes or leaving a needle in, and I don’t think you or anyone else could do it.
Of course someone could make it not work by injecting something into it. But I really don’t think it is possible to damage it by just leaving a needle in there, even if you were trying.
And think about it - a vial of insulin always has air in it. Air does not damage the insulin in a vial, so it wouldn’t damage it in a pen either.
But all of this comes down to how someone wants to handle it. If wiping the top and putting in a new needle every time is something that makes someone feel safer, then they should do it. If it seems like a hassle and is not worth the trouble, and they don’t worry about it, then they can skip it. It’s just a matter of finding your comfort level.
FWIW, my endo told me a long time ago that the rubber stopper on an insulin vial prevents bacteria from getting into the insulin.
I don’t normally worry about it (as stated above, the more “seasoned” diabetics, as I am, tend to be more loose with how they do this stuff)… but I’m curious, mostly so I don’t have to waste insulin. My friend mentioned the bacteria introduction due to reusing needles and not wiping. For a vial that will last more than a month I don’t want to throw it out, but if a pen won’t last as long (and the mechanism of delivery is different), then I don’t think it’s as big of a deal. Thanks for your thoughts.
@allison, not sure if this is useful, but I only prime my pens the very first use. It takes 3 or 4 units on the pen to get air out and insulin flowing the first time from what I’ve observed. After the pen is primed in general, I don’t worry about it after that unless I start getting wonky bg results after meals (I’m using pens for meals, pump for basal and corrections these days). YMMV
Oh that is good to know. The first time I used pens I didn’t know they needed primed (I had been pumping for 20 years; syringes before that)… so that made it difficult and I went back to syringes. It also didn’t help that one night I wasn’t sure which pen I had used in my sleep
“It also didn’t help that one night I wasn’t sure which pen I had used in my sleep ”
I was so rushed and tired w having babies in the house, I got to the point that I couldn’t remember if I had taken my Lantus or taken it twice. Got pretty scary.
I made the “hack” of buying a weekly pill sorter that was large enough to hold one pen needle per day. I would only use those specific pen needles for each daily dose of Lantus and that was a great way to keep track of whether I had taken my Lantus or not. Saved me many times.
I think I saw you mention that before! It’s a good idea. I just set a reminder to pop up on my phone and I don’t clear it until I take it, which works for me!
The problem I had was I kept both pens by my bed, so when I took a dose overnight, I wasn’t sure which pen I had used in the morning - did I take tons of long-acting? Short-acting??!
