Wil Dubois

Hey, All -- Got questions about life with diabetes? Then you've come to the right place! That would be our weekly diabetes advice column, Ask D'Mine, hosted by longtime type 1 and diabetes author Wil Dubois in New Mexico, who spent many years working as a clinical specialist helping those with diabetes.

This week, he takes on a trio of questions about needles and injection-related therapy. Here's Wil, "taking a stab" at this theme...

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

 

Natsu, type 1 from Japan, asks: Is it possible to hit an organ when inserting a diabetic cannula on the stomach? 

Wil@Ask D’Mine answers: Nope! Your innards are fully safe and secure. OK, in point of fact, most cannulas are worn on the “stomach,” so your worry is common. In fact, before my own diagnosis one of my wife’s aunts had type 2 requiring insulin, and I “knew” she took shots in the stomach. I ignorantly assumed she used some giant six-inch needle and had to insert this medieval torture device all the way into her stomach. Every day.

Under the circumstances, I found her to be a remarkably jolly person.

Later, when my own doctor calmly told me that I needed to take shots in my stomach, I nearly fainted. Of course, the truth is we take our shots into the insulating fat layer below the skin -- a layer of fat that even skinny people have, and is thicker than you’d think. Oh, and below that fat is a layer of muscle. The organs are below the muscle. So you can see you’ve got quite a bit of issue between the top of the skin an your internal organs. Even in svelte people, organs are buried deeper than you’d suspect.

Of course, those are syringe needles I’m talking about in my two examples, not pump cannulas, but cannulas are inserted with a guide needle, so it’s much the same.

Theoretically, I suppose, if you took one of those cannulas designed for 45-degree insertion, pulled your skin really tight and jammed it straight in, maybe you’d hit something. But it would likely be layer of muscle, not an organ.

So no fears. Used properly, your cannula will never meet your organs.

 

Sam, type 1 from Montana, writes: After reading about bi-hormonal pumps, I’ve decided to try some small boluses of glucagon for lows. I like the idea of not having to take in more calories every time I have a low blood sugar. But the needle is a harpoon! Why do glucagon kits have such large needles? Is it a thick liquid or can I use an insulin syringe?

Wil@Ask D’Mine answers: I looked high and low but I couldn’t find an answer to that question, at least not one from an official source. But that said, the liquid isn’t thick at all, and can be injected just fine with an insulin syringe, and there are actually plenty of people already doing so.

So why the harpoon? I suspect that the thick needle was selected because the kit is intended to be used by panicked civilians, not diabetes troopers like us. Oh, and of course the kit is designed for an intramuscular injection, called IM in the nursing biz, and that requires a deeper, and more robust needle to reach down through the skin than what we use for our insulin shots, through the fat, and solidly into muscle tissue. It’s not as scary as it sounds. Most immunizations—including flu shots—are IM.

But back to glucagon. Most of the folks playing around with micro-dosing of glucagon are taking it SubQ, which is a shallow shot into the fat right under the skin, like we do for insulin shots, and glucagon-shooters are in fact using insulin syringes, so I have no doubts than you can, too.

I agree with you that it would be great to fix lows without having to consume more carbs, which are calories we don’t need, that lead to weight gain we need even less. But remember that the shelf life of the glucagon is only 24 hours once mixed—a fact that’s still holding up the bi-hormonal pumps. That makes using glucagon as a first line treatment for your lows an expensive undertaking. Well, at least compared to a handful of Skittles.

 

Dixie, type 1 from Tennessee, asks: No bull, how many times can I really use a syringe?

Wil@Ask D’Mine answers: Once. No bull. Sorry. I know that’s not the answer you wanted.

Here’s the deal: Syringes have evolved tremendously over the last few decades. They’re now ludicrously small in diameter for one thing, and these tiny tubes have beveled points to make them yet sharper. The downside to these improvements, however, is the fact that they are actually quite delicate and damage easily.

Even when just used just once, the tip of the needle is already deformed. Used several times, it can be warped enough to start tearing skin, rather than smoothly piercing it. On top of that, modern syringe needles are coated like non-stick frying pans to make them slide into your skin easier—but that coating quickly wears off, usually after just one use.

So a used syringe is bent, torn, and no longer coated. It can cause bruises and can become painful to use. Designed, engineered, and manufactured for single use, the modern needle holds up poorly to repeated use, and you really should get a new one for each shot.

What’s that? How many times do I personally reuse mine? Once of course.

OK, OK. That is bull.

I use mine until they hurt.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.
Disclaimer: Content created by the Diabetes Mine team. For more details click here.

Disclaimer

This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.