• N Tubiana-Rufi, N Belarbi, L Du Pasquier-Fediaevsky, M Polak, B Kakou, L Leridon, M Hassan, and P Czernichow.
• Department of Pediatric Endocrinology and Diabetology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, France. nadia.tubiana@rdb.ap-hop-paris.fr
• Diabetes Care. 1999 Oct 1; 22 (10): 1621-5.

ObjectiveTo study whether 8-mm needles can reduce the frequency of intramuscular injections in diabetic children.Research Design And MethodsWe conducted a prospective crossover study in 50 children whose BMI was < or = 60th percentile to compare two lengths of needles (12.7 and 8 mm) regarding the occurrence of intramuscular injections as assessed by ultrasonography.ResultsThe frequency of intramuscular injections was 86% with the 12.7-mm needles and 38% with the 8-mm needles. The frequency of intramuscular injections was significantly reduced when using the 8-mm needles in the arms (P < 0.01) and thighs (P < 0.001). The efficiency of 8-mm needles, as defined by an intramuscular injection with a 12.7-mm needle and a subcutaneous injection with an 8-mm needle, was found for half of the children who injected in the arm and for two-thirds of the children who injected in the thigh. The subcutaneous tissue (SQT) thickness measured by ultrasonography with a skinfold was significantly higher (9.8 +/- 2.2 mm) in the group in which the 8-mm needles were efficient than in the group in which they were not efficient (6.8 +/- 2.1 mm, P < 0.0001). The efficiency of the 8-mm needle was not related to age, sex, BMI, percentile of BMI, injection device, or injection site. The sensibility and specificity of SQT thickness in predicting the efficiency of the 8-mm needles were both 79%.ConclusionsNeedles that are 8 mm long significantly reduce the risk of intramuscular insulin injection in slim or normal-weight (BMI < or = 60th percentile) diabetic children and adolescents.

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