How often do you recommend changing lancets?

Q: I change my lancet once a month. How often do you recommendchanging 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 procedurecreated a laceration, rather than a puncture. We’ve come a long way since then, withimproved spring-loaded devices, strips that require less blood and lancets that aresharper and usually coated with a lubricant. Lancets are now much more comfortable touse and less likely to cause a scar.

Today’s lancets are so good that they are commonly reused. The reasons to reuselancets are obvious: It’s cheaper and quicker not to have to change them each time; it’seasier not to carry extra lancets around; and, for some users, the lancets actually seemmore 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 rateof infections and injury from lancets is extremely low.

Many people, however, are not able to reuse lancets because they feel discomfortor they experience scarring if the lancet is not in optimal condition. Once a lancethas 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 theseindividuals, using a new lancet each time is well worthwhile.

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

Q: What do you tell your patientsabout reusing syringes?

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

For those who use syringes with needles and insulin in a vial, the situation may bemore complex. While I am not aware of widespread reports of infections or otherdamage caused by reusing insulin syringes and needles, it is possible forinsulin 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 isused.

While I don’t necessarily advocate reusing disposables,I know that many of my patients have been successfulwith such cost-saving measures, which also happento be convenient. I encourage my patients to look for newapproaches to day-to-day management of diabetes, andtogether we learn what works best.