Injecting Through Clothing

Treatment Insulin
1

I’ve been on a pump-vacation for a few weeks, and as I start to return to the “old habits” of multiple daily injections, I was reminded of this old conundrum: Do you inject insulin through clothing?

In 2013 I wrote this piece for Diabetes Mine on the topic. And the basic conclusion was, “Can’t see much harm.” Even though the one study on the topic was small. From the article:

The only official study on this practice dates back to 1997, when some researchers at Wayne State University in Detroit did a study on the subject. Published in the American Diabetes Association’s journal Diabetes Care, the study involved 50 PWDs, and 41 of those people completed the study, doing a total of 13,720 injections. The data found that injecting through clothing was a “rogue” technique, but concluded that it was indeed “safe and convenient.” None of the PWDs experienced problems at the injection sites, and only minor problems like blood stains on clothing and bruising, were recorded in their logbooks. Most of the people reported that injection through clothing offered benefits such as convenience and saving time (no kidding!).

Still, that study was done 15 years ago. And it also came at a time before insulin pumps were as mainstream as they are today, so people weren’t doing “multiple daily injections” the way they are today; the practice then was more likely two or three shots a day of an insulin mix.

For the article I also interviewed Larry Hirsch at BD (the needle-makers). His basic advice was “don’t do it.”

According to Dr. Larry Hirsch, the Vice President of Global Medical Affairs for Diabetes Care Business Unit at BD, the makers of many of the insulin syringes and pen needles used in the U.S., “hurt” is precisely why he thinks that injecting through clothing is a bad idea.

“When you inject this way you are blunting the needle and making it more resistant to glide through your skin and fat,” he said. “These needles were designed for injecting through the skin and we believe it’s the most appropriate way for them to be used.”

Dr. Hirsch was also critical of the old (and tiny) study on this topic saying that needles have evolved and in 1997 we were using thicker needles that were less likely to bend when getting pushed through clothing.

So…do you do it? When you’re in a hurry, have clothing that’s all tucked-in, or just lazy?

2

While I use a pump, I sometimes use a pen when I suspect a site may be fading. I did this during the night last night and bent a pen needle just going through my PJs. When the needle came out bent to a 45-degree angle, I was then faced with considering whether I received any insulin at all. Did the needle bend on the way in or the way out? I decided that I probably didn’t get any insulin and since it was only a two unit dose, I delivered it again, this time directly through my skin.

I still think shooting through clothes is a legitimate tactic in the real world but you need to be careful when you do it. In my example, removing my PJ pants would not have taken more than a few seconds. I will not do that again in those circumstances.

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3

not through clothes… just inject directly (no prep) into any piece of accessible skin.

i also don’t want blood on my clothes - it’s a pain to get out.

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4

I use a pump, but like @Terry4, there are times when I use a pen needle. I don’t generally like my stomach as an injection site, so many of my preferred sites (arms, calves) are exposed, or easily exposed most of the time. When I do decide to take an injection in my stomach, side or thigh, I almost always do it through my clothing. I have never had a problem with a bent needle from that, but did have a blood stain once. Of course, I was only Dx’d 4 years ago, so my experience is limited.

5

I used to, but I don’t do it very often anymore - only through very thin clothing. I’ve noticed that the thinner pen needles that have come out over the past few years do have more of a chance of bending. Heck, sometimes I’ve had them bend just going into skin alone!

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6

I definitely inject through clothing sometimes, including thicker clothing like jeans. I usually do my Humalog shots in my abdomen for faster absorption, and unless I’m wearing a dress, I lift my shirt for that, but my Lantus or any Humalog I want to absorb more slowly goes in my thigh, which is often through pants or something. I’ve never had a problem with it. Of course the company rep is going to say not to do it—I’m sure it is less ideal and has somewhat increased risks, but so does not changing your lancet, and I know very few diabetics who do that every time. I don’t really want anything to keep me from taking my shot when I need to—I think for me anyway, that’s a bigger risk. I do prefer the not super short pen tips though—I think some of the very short ones may end up a little too short if you go through clothes.

7

I’m not recommending that you inject through clothing.

But if you get any blood on your clothing, dip it in an appropriately sized container filled with cold, salted water. This gets the blood out without lysing the RBC wall, which would stain the clothing.

You probably already knew that…

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8

I have been on MDI for six years. I inject through my clothes all the time. My wife hates it, but it is practical and I consider it perfectly safe and effective. My wife even came with me to visit my endo in an attempt to dissuade me from the practice, but it didn’t work. I have diabetes. This is about my life. If it works, it works. Sorry some people don’t like it.

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9

I started injecting through my clothes in 1974 and i have never stopped. I figured my expirence as large as that small study

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10

I don’t- I tried it once or twice and I didn’t like it. I couldn’t see what I was doing and couldn’t tell for sure if it injected properly.

11

I don’t do it but from all the available data, I don’t see anything wrong with it. I do have to say something about the “blunt needle” theory, however. I think it’s . . . oh, let’s be nice: “horsefeathers”.

Unless it gets damaged by being dropped or something, I normally use each syringe for a week. Depending on the type of insulin, that generally means anywhere from 14 to 21 uses. By the end of the week I can just barely detect a difference. I’ve seen all the usual “studies” with striking microphotographs of how dull needles supposedly become after a few uses. Well, maybe if you’re pushing them through a steel-belted radial, perhaps, but that’s not what I do and those aren’t the results I experience.

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12

When I was on MDI, I never quite got my prescription and actual needed number of needles in sync - and my insurance didn’t help much on the copay for pen needles (I paid $40/box, that cost $44 retail and less at online pharmacies). So… I tended to get a script to an dicsount pharmacy and order out-of-pocket - to SAVE money. That exercise, though, made me reluctant to “waste” needles, so I definitely used them multiple times - sometimes as often as one pen needle per insulin pen. Maybe not quite a week at a time like you @David_dns, but close… Rarely, if ever- did I notice any difference between the first and last use - even thru jeans.

13

I’ve been on MDI three years and use the 4mm super fine needles. I would never, ever inject through clothing. For one thing, I bruise easily and have bruises all over my abdomen that I need to avoid, which I couldn’t see if I were doing it through clothing. Secondly, I’ve bent needles just getting them through my skin. I use each needle only once.

And finally, I’m a stickler for sanitation. I use an alcohol swab on the skin where I’ll do the injection as well as on the surface of the insulin pen before I attach the pen needle. I’m sure that most of the time one wouldn’t be accidentally injecting any contaminants that the body couldn’t handle, but with around 1500 injections a year, I’d rather avoid the possibility. It would only take once to get something nasty.

14

MDI for 2 years. I always inject my Humalog through my pants. I pull the front pants pocket up from the outside, inject, and then push the pocket back down. That way if I have a bleeder, it would stain the inside of the pocket, not my pants. I’ve never had any issues and only one bent needle.

15

I have been on a pump for a long time but back in the day when I was taking 5 shots a day, I did inject through cloths a lot. When taking that many injections, it was just easier. Since being on a pump, I still have needles in my kit for those just in case moments and I still inject through my cloths when I think here might be a problem with infusion set. I will say, it doesn’t last long because the needles are so fine. But it is my emergency needle and don’t need it often.
I did see a post somewhere of what needles, lancets look like after reusing. It is scary. So while I do reuse lancets, after seeing those pictures, I now change it once a day instead of every three days(infusion set change out).
But Mike, whatever works for you, go for it.:smiley:

16

I have tried a few time but I am always paranoid about did I take it? Did it all go through.
So just do it normally.
:blush:

17

I’m still in the “do what the doc says” stage…but we were told the only thing that’s acceptable to administer through the clothing is the Glucagon…the other stuff skin contact.

18

Yeah - doctors would say glucagon and an Epi-pen… heh

It’s like with babies and new parents… First baby, sterilize everything… Second baby, hm… hot water is good enough. Third (and more): wipe in on your shirt - there, it’s clean! :smiley:

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19

I hadn’t thought of it yet. I have reused needles and don’t sterilize =( on the go all the time. Glad I’m not the only one that bends the rules. !

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Only if I have my bathing suit on getting ready to go to the Y. Nancy