Author Topic: Needle size.. is there 5mm 32g available?  (Read 3809 times)

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Offline Imi.Masa

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Needle size.. is there 5mm 32g available?
« on: 05 March 2014, 03:39:03 PM »
Hi.

my niece has been using 4mm 32g needles for her insulin injections for quite some time now. she is 4 years old.
she now has to change to a longer needle, she has to change to 5mm. i don't want her to use 31g thickness, as it is too painful for her. does anyone know if i can get the 5mm size, but thinner than 31G? i was hoping for 32G, but haven't had any success finding it.

can anyone advise me the thinnest needle available for the 5mm size?

i would greatly appreciate any assistance or knowledge.

Thank you.

Imran

Offline Paul1976

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Re: Needle size.. is there 5mm 32g available?
« Reply #1 on: 05 March 2014, 03:55:14 PM »
Hi!

Did they give a reason why she has to start using 5mm needles instead of the 4mm ones she was using?

Regards

Paul
Type 1.5,Humalin I basal insulin,HbA1c 8.2% due to infection :( LCHF diet of 30 grams of carbs or below per day.
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Offline everydayupsanddowns

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Re: Needle size.. is there 5mm 32g available?
« Reply #2 on: 05 March 2014, 03:57:18 PM »
Hello Imran

Welcome to the foum! :)

Not sure why she is being made to change needle length if her current ones are suiting her well? It may also be worth trying different needle types at the different gauges as it may be other things (eg the type of lubricant) that are causing difference in sensation rather than the relatively small difference in needle diameter (31g is only 0.025mm wider than 32g)

There seem to be quite a few 4mm 32Gs and several longer lengths at the same gauge, but few at 5mm

Insupen appear to offer both 6mm and 8mm at 32G though these might be a bit long for a small person
NovoTwist offers 5mm at 32G but they are pretty pricey
GlucoRX fine points are all 31G but are more cost effective than many other shorter needles which may help if your GP is complaining about the cost of the shorter needles.

Though as I say, it would be interesting to know *why* the change is being made. I know several adults who are happily using 4mm needles.

Good luck with your search!
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline Liam

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Re: Needle size.. is there 5mm 32g available?
« Reply #3 on: 05 March 2014, 04:31:59 PM »
I wonder if the extra mm is causing issues with it hitting the muscle maybe making it more painful? Since the 0.025mm seems unlikely to be that noticeable. Others have posted about the other issues above.
DX Type I 1994.    Novorapid Animas Vibe pump
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Offline Pattidevans

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Re: Needle size.. is there 5mm 32g available?
« Reply #4 on: 05 March 2014, 05:17:10 PM »
Hi Imran and welcome to the forum.

I'm sorry to hear about your neice's problems.  BD needles come in 4mm 32g and I was using those as an adult until I went onto the pump. What have they given as a reason for her changing to a longer needle?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Fergus

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Re: Needle size.. is there 5mm 32g available?
« Reply #5 on: 05 March 2014, 09:21:42 PM »
A listing of 32 gauge 4 mm needles per NHS Electronic drug tariff:

Unifine Pentips 4mm/32 gauge
Nanopass 4mm/32.5 gauge 
Mylife Penfine Classic 4mm/32 gauge
Mylife Clickfine 4mm/32 gauge
Microdot Droplet 4mm/32 gauge
Insupen 4mm/32 gauge
BD Micro-Fine Ultra (formerly BD Micro-Fine+) 4mm/32 gauge

Hope this helps with sugestions
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Offline Pattidevans

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Re: Needle size.. is there 5mm 32g available?
« Reply #6 on: 05 March 2014, 10:19:02 PM »
How do the prices compare Fergus?
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Fergus

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Re: Needle size.. is there 5mm 32g available?
« Reply #7 on: 05 March 2014, 11:42:34 PM »

Prices per NHS Electronic drug tariff:

Unifine Pentips 4mm/32 gauge £11.75/100
Nanopass 4mm/32.5 gauge  £12.25/100
Mylife Penfine Classic 4mm/32 gauge £5.94/100
Mylife Clickfine 4mm/32 gauge £12.32/100
Microdot Droplet 4mm/32 gauge £6.65/100
Insupen 4mm/32 gauge £12.05/100
BD Micro-Fine Ultra (formerly BD Micro-Fine+) 4mm/32 gauge £12.69/100

Hope this helps
site :
http://www.ppa.org.uk/edt/March_2014/mindex.htm
T2,  Diagnosed 2008.
CKD III/IV, Bleed Stroke Survivor.
Was( Lantus 20u, Novorapid 3x18u )Then Gliclazide 20mg,Now Nil!
Xpert grad 2009.
Completed BDEC course
Self-management of Long-term Health Conditions
 Programme
Trying to keep Carbs Low.
Results
Dec HbA1c 5.5 Chol 3.8 Trig 0.66 HDL 1.25 LDL 2.2

I love my collies, they love me

Offline Pattidevans

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Re: Needle size.. is there 5mm 32g available?
« Reply #8 on: 06 March 2014, 12:18:39 AM »
Thanks Fergus

I see they're all about the same price with the exception of Mylife Penfine Classic & Microdot Droplet.  Odd, on another thread someone was being forced onto GlucoRX on cost grounds.  Probably not 32gauge though.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Imi.Masa

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Re: Needle size.. is there 5mm 32g available?
« Reply #9 on: 06 March 2014, 08:46:00 AM »
Hey Everyone.

thank you so much for your help.

the reason she has to change the length of the needle is  that it is possible that 4mm no longer goes deep enough to get to her blood supply, so she doesn't get her full dose.

she refuses to be injected directly into her stomach, so we inject into her arms and legs (thighs).

it was interesting to find out to know that even adults are using the 4mm size with out any issues. maybe its due to the differences when you inject into your stomach and when you inject into your limbs?

thanks a lot for your help. her father has told me he has ordered 5mm 32G through a pharmacy, although he does not know the brand yet. I am a bit skeptical, as i have researched this thoroughly and have not found this size.

as "everydayupsanddowns" mentioned, only Novatwist has that size, and it only works with their pen, as it is a twist and click needle (something new).

well anyway, lets see what progress we make, i hope her dad gets the size she needs.

your help has been much appreciated, really it has.

if there as any more advice you have for us, or think we are making the wrong decisions, please feel free to advise us. i look forward to it.

Thank you.

Regards,

Imran

Offline everydayupsanddowns

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Re: Needle size.. is there 5mm 32g available?
« Reply #10 on: 06 March 2014, 09:19:18 AM »
Thanks Fergus

I see they're all about the same price with the exception of Mylife Penfine Classic & Microdot Droplet.  Odd, on another thread someone was being forced onto GlucoRX on cost grounds.  Probably not 32gauge though.


GlucoRx's are all 31G and all cost exactly the same no matter what length (7p each IIRC) Many manufacturers seem to heavily load the shorter length needles - sometimes almost 2x the cost :eek:
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline everydayupsanddowns

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Re: Needle size.. is there 5mm 32g available?
« Reply #11 on: 06 March 2014, 10:13:12 AM »
if there as any more advice you have for us, or think we are making the wrong decisions, please feel free to advise us. i look forward to it.

Glad that some have been found that she can try.

The last time I looked into needle lengths I was slightly surprised by a couple of things...

1. For adults (don't know about children), the depth of the skin is pretty much identical no matter what weight and size people are. In order to get to the 'subcutaneous' tissue a short needle can be equally appropriate and effective for a 20st man as for a willowy 8st young woman.
2. Shorter needles are not necessarily more comfortable
3. Some reports seem to suggest the depth of insulin injection alters absorption... but others don't find any difference

So once again it seems to boil down to experimenting and working out hwat works best for the individual.
Mike

Type 1 since: 1991 Last HBA1c: 45 (6.3%)  Total Chol 5.0 (1.9HDL / 2.8LDL / Trigs 0.7)
Pumping NovoRapid in a MiniMed 640G
Blogging at: www.everydayupsanddowns.co.uk

Offline Pattidevans

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Re: Needle size.. is there 5mm 32g available?
« Reply #12 on: 06 March 2014, 10:43:33 AM »
Imran


Insulin isn't meant to be injected into her blood supply.  It is supposed to be injected into the thin layer of adipose tissue just beneath the skin.  Injecting it into muscle (which is what may happen with longer needles if your niece is skinny) is not recommended as it speeds absorption too fast.  I used 4mm (at the recommendation of the Diabetes specialist Nurse ) in both my stomach and thighs.  Tummy has plenty of fat, thighs practically none.  As Mike says skin thickness varies little or not at all between large and small people.


I don't know what insulins your niece is on, but I think what might be happening in her case is that she is growing and that she well may need her  insulin dose increasing as insulin is usually titrated by kilo of body weight.  Even adults have varying insulin needs from time to time depending on various factors.


Who looks after your niece's diabetic care, is it a GP or a Diabetes Specialist at a paediatric diabetes clinic?  If it's a GP I suggest you ask for a referral to a proper clinic and if she is already cared for by a clinic you need to discuss these issues with the nurse there.


Hope this helps.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline nytquill17

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Re: Needle size.. is there 5mm 32g available?
« Reply #13 on: 06 March 2014, 12:18:38 PM »
I was diagnosed at age 10 over 18 years ago now. As time goes, needle technology and our understanding of injections have improved which means I actually started with 10mm needles as a child and have gradually gone from that to 8, 6, and now as an adult am using 4mm! So I actually ended up using shorter needles the bigger I got! I could not imagine going back to a longer length now, 4mm is much more comfortable and does the same job as far as absorption, maybe even a better job!

Like Patti, I suspect her insulin needs may be changing. The same hormones that cause children to grow and develop as they should unfortunately also cause blood sugars to go higher and insulin to work less well (insulin resistance). Which means that growing children often need their insulin doses changed quite frequently to keep up. At certain times they may need quite a bit more than before, at other times not so much. This is completely normal both for children and adults, but is often more pronounced in growing kids.

If nothing else though, having 5mm ones to try will let you rule out (or rule in!) needle length as the issue. In a few people it does seem to make a difference although changing insulin dose needs is much more likely (and happens to every diabetic no matter what size needle they use).
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Offline Imi.Masa

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Re: Needle size.. is there 5mm 32g available?
« Reply #14 on: 09 March 2014, 12:31:00 PM »
Hi.

sorry for the delay in response.

I have taken into account all of the advice you have given me/us.

although I was aware that insulin is not meant to be injected directly into the blood stream,  i did not know that the skin thickness does not vary too much from kids to adults.

my niece has a Diabetes specialist who specifies her doses, and all other relevant instructions/decisions.

she has an appointment with the specialist soon, and thankfully, due to your help, her parents will raise a few issues at their next appointment.

Thanks again, for all your help, and if I gain any valuable information, I will surely share it here.

As always, any advice is greatly appreciated.

Regards,

Imran