N. Tubiana-rufi et al., Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes, DIABET CARE, 22(10), 1999, pp. 1621-1625
OBJECTIVE - To study whether 8-mm needles can reduce the frequency of intra
muscular injections in diabetic children.
RESEARCH DESIGN AND METHODS - We conducted a prospective crossover study in
50 children whose BMI was less than or equal to 60th percentile to compare
two lengths of needles (12.7 and 8 mm) regarding the occurrence of intramu
scular injections as assessed by ultrasonography.
RESULTS - The frequency of intramuscular injections was 86% with the 12.7-m
m needles and 38% with the 8-mm needles. The frequency of intramuscular inj
ections 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 define
d by an intramuscular injection with a 12.7-mm needle and a subcutaneous in
jection with an 8-mm needle, was found for half of the children who injecte
d 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 th
e 8-mm needles were efficient than in the group in which they were not effi
cient (6.8 +/- 2.1 mm, P < 0.0001). The efficiency of the 8-mm needle was n
ot related to age, sex, BMI, percentile of BMI, injection device, or inject
ion site. The sensibility and specificity of SQT thickness in predicting th
e efficiency of the 8-mm needles were both 79%.
CONCLUSIONS- Needles that are 8 mm long significantly reduce the risk of in
tramuscular insulin injection in slim or normal-weight (BMI less than or eq
ual to 60th percentile) diabetic children and adolescents.