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Kos Diabetes Group: Needle Phobia [1]

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Date: 2022-09-09

Many people fear diabetes, not because of all the complications but because they fear having to give themselves a shot every day. A small degree of dislike of needles is perfectly normal – most people would avoid them if they possibly could. But this fear is heightened in people with needle phobia, to the point where they cannot bear the thought of injections.

But for many people with diabetes, injections are a necessary part of life. For some, both newly diagnosed and those who have been managing the condition for many years, the injection process can be very distressing.

Dislike of needles

Needle phobia is common in the general population – some studies suggest the rate of occurrence is as high as 10%. About 1/3 of the approximately 27 million US citizens who have diabetes use insulin. It’s no surprise that there are many people with diabetes out there dealing with needle phobia.

Fear of self-injecting and fear of self-testing are common among adolescents with Type 1 diabetes. Therefore, it is essential to take the extra steps in their diabetes education to lower the risk factor of fear of injections and help them be more complaint with testing and dosing.

Symptoms of needle phobia

The symptoms of needle phobia can vary greatly from one individual to another. The main feature is anxiety at the thought of injections, leading to avoidance of injections.

This anxiety may be associated with:

feeling dizzy and light-headed

a dry mouth

palpitations

sweating

trembling

over-breathing

feeling sick

even fainting

Why does it occur?

Although it can be difficult to be entirely sure what causes a phobia, the most common causes are thought to be:

An upsetting experience with needles when young, for example, a painful procedure at the hospital or at the dentist

A fear that has been ‘modelled’ by an adult close to the child, either through actual observation of their fear, or being told a story that implied injections and needles were very painful.

There is evolutionary value to a fear of needles. In the past, an individual with a fear of being stuck with a thorn or a knife was less likely to die in accidents or in encounters with hostile animals or other humans. Prior to the 20th century, even an otherwise non-fatal puncture wound had a reasonable chance of causing a fatal infection, so a trait that had positive survival value before the 20th century now has the opposite effect as it means people struggle to engage in valuable healthcare regimes currently available.

If you (or someone you support or care for) is diabetic and also has a fear of needles, there are steps you can take to help overcome the fear.

Practice holding an insulin syringe or insulin pen in your hand. Start with no needle and hold it until you don’t feel any anxiety. Then place a capped needle on the syringe or pen and hold it until you feel comfortable.

Practice drawing up the correct dosage of insulin until you no longer experience fear.

Act ‘as if’ you are going to inject, without actually doing so. Hold a syringe or pen with no needle against your skin.

Inject (perhaps into the stomach first as many people find it less painful as there are few nerve endings there)

Inject in other parts of body – thigh, buttock – also known as alternate site injections.

Inject in different locations like at a friend’s house or in a restaurant.

Here are some ideas to help make injections less painful

Change your insulin delivery system. You can use an injector device which hides the syringe from site. Two of the most popular ones are the Inject-Ease and the Autoject 2. To use the Inject-Ease, place your insulin syringe into the device and place the tip of the device against your skin and press the button. The Inject-Ease automatically moves the needle into the skin. You never see the needle, and the tip of this device is designed to reduce the sensation of pain at the injection site. For more information, visit the Inject-Ease website.

The Autoject 2 is another type of auto-injector device that hides the syringe and needle, making it easier to give an injection. For more information, visit the Autoject 2 website

Another switch to consider is going to an insulin pump. Instead of having to inject multiple times a day, you only need to switch out your infusion set once every 2-3 days. Using a CGM will also cut back on the numerous fingersticks necessary to monitor glucose levels.

Use a cold spoon. One of the most simple and effective methods is to put a frozen spoon or an ice cube (wrapped in a handkerchief or napkin) on the injection site for a few minutes before injecting. The cold has a numbing effect and makes the injection less painful.

Use pressure. This is another easy trick, but one that works well. Simply press down with your thumb for about 20 seconds right on the place you intend to inject. The area will be briefly less well supplied with blood and the injection will hurt less.

Use a pain blocking device Buzzy is a cute little bee shaped device aimed at children who are scared of insulin injections (or any injection really so it could be used by non-diabetics for routine vaccines as well), but there’s no reason adults can’t use it, too. Buzzy works by using cold and vibration to block pain signals. Learn can learn about Buzzy by copying and pasting the URL below into your browser. (I tried to do the embedded link but it just wouldn’t work).

https://paincarelabs.com/collections/buzzy%C2%AE?utm_term=%2Bbuzzy%20%2Bpain%20%2Brelief&utm_campaign=BSD+%7C+Branded&utm_source=adwords&utm_medium=ppc&hsa_acc=8668101209&hsa_cam=12428524479&hsa_grp=121964331481&hsa_ad=501222965706&hsa_src=g&hsa_tgt=kwd-303939683650&hsa_kw=%2Bbuzzy%20%2Bpain%20%2Brelief&hsa_mt=b&hsa_net=adwords&hsa_ver=3&gclid=EAIaIQobChMI5MHa6sb--QIVJsmUCR0aBwAzEAAYAiAAEgInn_D_BwE

Use a cream or patch. There are creams and patches available that numb the area and make the injection less painful. Some are prescription products and others can be purchased over the counter. These often have to be applied some time beforehand so they can absorb and start working, so some pre-planning is necessary to use them effectively.

Change your needle To avoid unnecessary pain during an injection it’s important to use a new needle for each injection.

Today’s lancets and needles are a vast improvement when it come to thickness (gauge) and length compared with lancets and needles of years past. Smaller, thinner lancets and needles mean less pain. Less pain can mean less fear. Ask your doctor to write a prescription specifically for the shortest, thinnest needles possible to avoid substitution with another size needle.

Also, ask your physician to prescribe a high gauge lancet, such as a 33-gauge lancet (the higher the gauge, the smaller the needle size) to help make fingersticks less painful as well. Also try setting the depth gauge of your lancet device to a lower setting if you find fingersticks to be painful.

If you have a fear of needles, it’s important to take steps to overcome it, especially if your fear is keeping you from testing or using your insulin the way you should. Talk to your healthcare provider to see what steps would be appropriate for you to take to help alleviate your fear.

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[1] Url: https://www.dailykos.com/stories/2022/9/9/2121547/-Kos-Diabetes-Group-Needle-Phobia

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