title: Short needles (8 mm) reduce the risk of intramuscular injections in children with type 1 diabetes.
abstract: OBJECTIVE
  To study whether 8-mm needles can reduce the frequency of intramuscular injections in diabetic children.
  
  
  METHODS
  We conducted a prospective crossover study in 50 children whose BMI was < or = 60th percentile to compare two lengths of needles (12.7 and 8 mm) regarding the occurrence of intramuscular injections as assessed by ultrasonography.
  
  
  RESULTS
  The frequency of intramuscular injections was 86% with the 12.7-mm needles and 38% with the 8-mm needles. The frequency of intramuscular injections 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 defined by an intramuscular injection with a 12.7-mm needle and a subcutaneous injection with an 8-mm needle, was found for half of the children who injected 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 the 8-mm needles were efficient than in the group in which they were not efficient (6.8 +/- 2.1 mm, P < 0.0001). The efficiency of the 8-mm needle was not related to age, sex, BMI, percentile of BMI, injection device, or injection site. The sensibility and specificity of SQT thickness in predicting the efficiency of the 8-mm needles were both 79%.
  
  
  CONCLUSIONS
  Needles that are 8 mm long significantly reduce the risk of intramuscular insulin injection in slim or normal-weight (BMI < or = 60th percentile) diabetic children and adolescents.
authors.affiliation: Department of Pediatric Endocrinology and Diabetology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, France. nadia.tubiana@rdb.ap-hop-paris.fr
authors.forename: N
authors.initials: N
authors.lastname: Tubiana-Rufi
authors.forename: N
authors.initials: N
authors.lastname: Belarbi
authors.forename: L
authors.initials: L
authors.lastname: Du Pasquier-Fediaevsky
authors.forename: M
authors.initials: M
authors.lastname: Polak
authors.forename: B
authors.initials: B
authors.lastname: Kakou
authors.forename: L
authors.initials: L
authors.lastname: Leridon
authors.forename: M
authors.initials: M
authors.lastname: Hassan
authors.forename: P
authors.initials: P
authors.lastname: Czernichow
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004867:Equipment Design; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D007223:Infant; D007273:Injections, Intramuscular / Q000009:adverse effects*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D009339:Needles / Q000009:adverse effects; D011446:Prospective Studies; D012885:Skinfold Thickness
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin