Comparison Between Shorter Straight and Thinner Microtapered Insulin Injection Needles

Abstract

The BD32S4 needle was more highly evaluated and was preferred by the patients with respect to pain during injection, usability, and visual impression, without having a negative impact on glycemic control. The overall preference of patients for the shorter needle in this study suggests that needle length may be one of the major contributing factors for patients' comfort in insulin injection, although the other relevant factors of needles still need to be considered.

Intramuscular Risk at Insulin Injection Sites—Measurement of the Distance from Skin to Muscle and Rationale for Shorter-Length Needles for Subcutaneous Insulin Therapy

“…12 Prospective, controlled trials (mostly crossover studies) comparing different length needles have consistently found equivalent glycemic control, less pain, and minimal ''backflow'' or skin leakage with shorter lengths, which patients usually prefer. 8,9,[15][16][17][18][19] A randomized, controlled study confirmed these outcomes for a 4 mm · 32 gauge pen needle, versus 5 mm and 8 mm · 31 gauge needles, in adults with diabetes and BMI up to 49 kg/m 2 ; a post hoc analysis showed equivalent glycemic control without increased skin leakage for the 4 mm needle in the obese subjects, similar to the nonobese ones. 16,20 A prospective randomized, controlled crossover study in obese patients (BMI up to 60 kg/m 2 ) has been reported and confirms such findings for the 4 mm-length needle compared with both 8 mm-and 12.7 mm-length needles.…”

“…Most patients using needles ‡ 6 mm in length must either inject at an angle and/or raise a skinfold (''pinch-up'') to effectively reduce IM risk; 4 and 5 mm pen needles are a safe and equally effective alternative. 12,[15][16][17][18][19] The persistent use of 8-12.7 mm needles for insulin therapy appears to be based on habit and clinical inertia, without any evidence of superior metabolic control or reduction in injection problems, such as leakage or backflow from the skin. 8,12,15,16,19 Such needles are longer than is necessary for consistent SC drug delivery and offer no inherent advantage.…”

Indian Injection Technique Study: Population Characteristics and Injection Practices

“…The 4-mm needle was judged by Japanese patients to be less painful and easier to use. Nagai et al [27] compared 4-mm/32G to 5-mm/33G (tapered) needles and found similar results. Hirose et al [28] performed PK/PD studies which showed bioequivalent maximum concentration and area under the curve for the 4-mm/32G needle relative to the 6-mm/32G and 8-mm/31G needles.…”

Subcutaneous Injection Depth Does Not Affect the Pharmacokinetics or Glucodynamics of Insulin Lispro in Normal Weight or Healthy Obese Subjects

“…5 More recent data in Japanese patients have showed no differences in glycemic control between 4-mm and 5-mm needles 14 and no differences in the exposure to insulin between 4-mm, 6-mm, and 8-mm needles. 13 Patients need to have their insulin reliably delivered into the SC tissue without discomfort, leakage, or injection site adverse effects.…”