Sunday, May 15, 2011

Reusing needles

Growing up with [type 1] diabetes there were a few non-talked about norms: taking insulin shots through bathing suits, telling my parents my blood sugar was "normal" when I actually forgot to check, sneaking Halloween candy from the pile piece by piece, and pushing off changing pump sites until I ran out of insulin. However, there were other big no-nos that I never messed with out of fearing serious complications. One of these was reusing sterile disposable insulin syringes. My doctors had taught me that I should never reuse them as the needle blunts, the plastic breaks down, and that injecting myself and then reintroducing the needle into the sterile insulin bottle allows for the propagation of bacteria. I knew of people who reused needles on insulin pens, but no one who did so with disposable syringes.

Imagine my shock last week when we sent a newly diagnosed [type 2 diabetes] patient home with a prescription for a 1 month supply of insulin and only 6 needles. I looked at my attending like he was crazy! He looked back at me like I was a naive medical student who had never met a diabetic before. When I voiced my concerns, he sent me to google. I was shocked to find out that there is actually little risk in reusing your own disposable insulin syringes. There is this article in The Lancet in 1983, and this article was published in 1989 in General Internal Medicine. Even the Pediatric Advisory Network came out with tips for more safely practicing syringe reuse in 2010. Sure, there are some naysayers too. Take for example BD's statement on this issue. BD happens to be on the big syringe manufactures so it is really shocking that they don't encourage the practice (sarcasm).

This has gotten me thinking about what other practices exist in chronic illness communities to lower costs and reduce medical waste? Where else is there significant discourse between the scientific literature and the company/suppliers stance? How else can I better advocate for my future patients instead of simply support the industry?

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