A reality of managing type 1 diabetes is that there are needles involved. The needle may be in the form of a lancet for doing finger sticks, a syringe needle, a pen needle or a needle to insert an infusion set for a pump or a sensor for a CGM. It’s probably fair to say that practically no one actually enjoys getting or giving themselves an injection; yet many people do this every day, multiple times a day, often without any grumbling or complaint. On the other end of the spectrum, it’s estimated that up to 10% of the population has a needle phobia, which, according to the International Classification of Diseases, is defined as “the fear of injections and transfusions.
So, needle phobia is real and is not to be taken lightly!
Needle phobia undoubtedly affects your diabetes management. A study showed that patients with type 1 diabetes who exhibited more fear of needles had uncontrolled blood glucose levels.1
If you identify with the above, then we know you are struggling. In this article, we’ll try and provide you with some tips to help you manage your needle anxiety better, but first, it is of use to understand what happens in your body every time you experience this needle-associated fear.
So, how does that happen?
A nervous system reflex is responsible for some of the symptoms associated with needle phobia. You may feel clammy or cold, turn pale, feel nauseous, or have difficulty breathing when in the presence of a hypodermic needle. You may feel sweaty or tingly, and your blood pressure may drop. To make matters worse, the skin surface may become hypersensitive, making injections seem ever more uncomfortable.2
Now, what should you do?
1. Remember, you are not alone!
Fear of needles is more common than you might think.1,2
Fear of needles is greatest in children, especially younger children and decreased with age. In adolescents,
20-50% have a fear of needles, while the percentage decreases to 20-30% in adults.1
While many needle-phobic people may not talk about it, they are out there. Realize that your needle phobia is most likely an inherited condition, and that your reaction to needles is involuntary. It’s not ‘all in your head.’
2. Practice some of the following techniques to help you lessen the symptoms and pain you are experiencing:2
- Use topical anesthesia at the needle site (ice, ethyl chloride spray, or topical anesthetic creams). Only the surface of the skin will be numb but the initial shock of the puncture may be decreased.
- Avoid the sight of the needle puncturing the skin. Place cloth between needle point and skin when injecting medications; use pens, syringes, and lancing devices that have covered caps.
- Reduce pain when injecting insulin by pinching the skin (avoid inserting the needle into muscle) and using fine gauge and short needles. Penetrate the skin quickly with minimal hesitation.
- Minimize the pain of lancing the finger tips by using fine gauge lancets, using the sides of the fingertips, or switching to alternate site testing.
It is always a good idea to talk to your doctor about your doubts and fears. Your doctor is a trained healthcare professional who deals with injections daily. They will be able to also give you practical information on how to deal with your needle phobia, and ensure you get the care you need.
References: 1. McLenon J, Rogers M. The fear of needles: A systematic review and meta-analysis. Journal of Advanced Nursing. 2018;75(1):30-
42. 2. Scheiner G. Fight the Phobia! Fear of needles Can be conquered. Integrateddiabetes.com. 2007 [cited 22 June 2020]. Available from: