Q: I change my lancet once a month. How often do you recommend changing lancets?

A: In the early days of blood glucose self-monitoring, pricking the finger to get a “hanging drop” of blood often hurt and left a scar. This was because the procedure created a laceration, rather than a puncture. We’ve come a long way since then, with improved spring-loaded devices, strips that require less blood and lancets that are sharper and usually coated with a lubricant. Lancets are now much more comfortable to use and less likely to cause a scar.

Today’s lancets are so good that they are commonly reused. The reasons to reuse lancets are obvious: It’s cheaper and quicker not to have to change them each time; it’s easier not to carry extra lancets around; and, for some users, the lancets actually seem more comfortable after being “broken in.”

Since the lancet goes into the subcutaneous space and is not being used intravenously, and since blood is flowing out of the body, sterility is generally not an issue. The rate of infections and injury from lancets is extremely low.

Many people, however, are not able to reuse lancets because they feel discomfort or they experience scarring if the lancet is not in optimal condition. Once a lancet has been used, its surface is rougher, the lubricant wears off and the point is duller. Any handling of the lancet, such as cleaning with alcohol, tends to worsen it. For these individuals, using a new lancet each time is well worthwhile.

My patients find out pretty quickly if they can reuse their lancets. I’m supportive of any solutions that work and that are safe, especially if it leads to increased self-monitoring of blood glucose levels, which is necessary for them to make informed decisions about insulin doses, meal planning and exercise scheduling.

Q: What do you tell your patients about reusing syringes?

A: The arguments for and against reuse of disposable needles, whether attached to insulin syringes or to insulin pen cartridge-based systems, are similar to those for lancets. Insulin is injected subcutaneously, not intravenously. Therefore, cleanliness rather than sterility is the requirement for safe injections. I am, however, concerned about local skin trauma caused by a used needle that is less sharp and smooth than a new needle and that is no longer lubricated.

For those who use syringes with needles and insulin in a vial, the situation may be more complex. While I am not aware of widespread reports of infections or other damage caused by reusing insulin syringes and needles, it is possible for insulin in the vial to become contaminated. The potential for precipitation of insulin in the needle may also be a problem, especially if more than one type of insulin is used.

While I don’t necessarily advocate reusing disposables, I know that many of my patients have been successful with such cost-saving measures, which also happen to be convenient. I encourage my patients to look for new approaches to day-to-day management of diabetes, and together we learn what works best.