Patient perceptions of injection pain and anxiety: a comparison of NovoFine 32-gauge tip 6mm and Micro Fine Plus 31-gauge 5mm needles.
BACKGROUND
Injecting insulin may cause pain and anxiety and lead to suboptimal treatment of diabetes mellitus. The aim of this randomized, open-label, crossover study was to compare two types of needle design and diameter in patients with diabetes injecting insulin.


METHODS
Patients with diabetes injecting insulin twice daily for at least 3 months were included. A NovoFine (Novo Nordisk, Bagsvërd, Denmark) 32-gauge tip 6mm tapered needle and a Micro Fine Plus (Nippon Becton Dickinson Co. Ltd., Tokyo, Japan) 31-gauge 5mm standard needle were compared. Patients were randomized to use one needle for 1 week, followed by the alternative needle for another week. Before and after each week patients completed a 14-item questionnaire assessing overall satisfaction and usability of the needles. Each item was scored on a visual analog scale from -100 (worst) to +100 (best).


RESULTS
Thirty patients (24 men, six women) took part in this study: 24 with type 2 diabetes and six with latent autoimmune diabetes in adults. The mean +/- SD for age was 57.8 +/- 7.6 years, for body mass index was 23.0 +/- 3.1 kg/m(2), for duration of diabetes was 15.6 +/- 9.8 years, and for mean glycated hemoglobin was 7.1 +/- 1.1%. Patients were more satisfied with the use of NovoFine 32-gauge tip 6mm needles (P < 0.0001), found the needles less frightening (P < 0.05) and less painful (P < 0.01), and caused less frequent bleeding and bruising (P < 0.001) than Micro Fine Plus 31-gauge 5mm needles.


CONCLUSIONS
These results suggest that the diameter and design of the needle play an important role in reducing injection pain and needle anxiety, which is particularly important for insulin initiation.
Iwanaga
Midori
M
Center of Diabetes and Endocrine & Metabolism Disease, Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan.
Kamoi
Kyuzi
K
D000368:Aged; D001007:Anxiety / Q000209:etiology*; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004867:Equipment Design; D005239:Fear; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009339:Needles; D010146:Pain / Q000209:etiology*
D007004:Hypoglycemic Agents; D007328:Insulin