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Painful Insulin Pen Injection - Ideas?

Discussion in 'Adults with Type 1' started by MrsBecky, Jun 10, 2011.

  1. MrsBecky

    MrsBecky Approved members

    Jun 3, 2011
    Daughter (13 yrs old) dx 5/18 and started insulin pen injections that day. The past couple of days she has been complaining the pain of the injections is getting worse. Tonight she wanted to skip the Levemir because it was to painful. Not an option - I gave her the choice either she did it or I did....she was upset, but did it. She states that both the Levemir and Novolog pens are painful and shed many tears.

    Any ideas on why the injections would be more painful? Any way to help with this?

    Any input would be greatly appreciated.
  2. Renegade

    Renegade New Member

    May 26, 2011
    Hey Becky,

    I was diagnosed at age 14 in 1974. I remember what it was like, and I've had thousands and thousands of injections in the years since. This voice of experience says injections do NOT have to be painful. And if they are, it can easily be remedied.

    First, sad but true, just because someone is a diabetes educator or even an MD, it doesn't mean they are giving your daughter good advice on the best way to give herself injections. I'm not saying she's gotten bad advice; I have no way of knowing. I just know I've gotten my share of lousy advice over the years. I'm talking both technique and injection sites. For instance, when I was diagnosed, I was told to use sites on my arms and legs. With no fat to speak of on my arms, I injected mostly into my thighs for years, and had my share of painful injections. I got older, read, researched, experimented, and found what works for me. I could write a lot, but with limited time right now, here's a few things:

    1. The biggest difference for me, by far, was learning to relax my body before the injection. We all hold tension in different places in our bodies, and this, combined with fear (of the needle, and of pain) creates a mind-body condition that is conducive to pain. So relaxing the body and the mind, and letting go of fear (or just relaxing with the fear) creates the optimal condition for painless injections. Holding (in your mind) the fear of "puncturing" your skin with the needle, as you're holding the syringe (or pen) in your hand, will cause you to tense up and "brace for impact." This is the opposite of what you want for painless injections. It may take some practice, but have her imagine her body being open and soft and receptive to the insulin. Sometimes I have stood with the syringe in my hand for several minutes until I can get to that state where I'm relaxed and no longer braced for impact or fearing the "stab." So I wait, I breathe deeply, and let my awareness sink into my body (and out of my head).

    2. The sites that work best for me are the buttocks and abdomen. Plenty of fat, extra skin to pinch up (which I was taught to do, but haven't for years), and just easy to get to.

    3. The length and gauge of the needle can also make a difference. While I generally use the short needles for Novolog (injections of less than 15 units), I find that the standard length 1/2 inch or even 5/16" works better for my Lantus injections (20+ units). Insulin needles can vary between 28 gauge and 31 gauge. The 31 gauge needles are the thinnest, and that's what I prefer.

    4. Dr. Bernstein's Diabetes Solution (book) has some good info on injection technique. In a nutshell, he recommends a quick motion, which I agree with (when I was 14, I imagined I was harpooning a whale). The idea is that inserting the needle is NOT something you want to do slowly. I may take my time getting to the point where I'm ready (and this gets easier and quicker with practice), but once I am, I go for it. I don't recommend everything in Dr. Bernstein's book by any stretch, but he is a type 1 himself and he knows how to give himself shots (and he does have lots of fans).

    Hope this helps. I'd be happy to share more if you or your daughter is interested.
  3. sarahspins

    sarahspins Approved members

    May 5, 2009
    I would try different pen tips - I prefer BD over Novo, and have had very bad luck with the generic pen tips (like ReliOn at walmart, etc), but others have different experiences.

    You can also potentially try shorter/longer needles. Sometimes the shorter ones hurt less going in, but you end up with more pain while injecting. I tried the 4mm nano needles and didn't like them because of that - but I use the 5mm when I am no MDI with no problems. If you are using the 8mm I'd absolutely try some of the shorter ones. Novo makes 6mm (in three different gauges.. 32g is the finest) and BD makes 5mm (31g) and the 4mm (32g). You can buy all of these OTC (but at a premium) or you can ask your Dr for samples or an RX. All of the screw-on pen tips are universal - they'll fit on anything.

    I would ask her if it's the poking or the injecting that is hurting her - figuring that out may help you find a better solution.
  4. Ronin1966

    Ronin1966 Approved members

    Feb 18, 2010

    Another possibility... where are you storing her pens??? If its in your fridge it could very well be the insulin is @()#*@(#@#@&n COLD :eek:. That hurts!

    A solution (which is old school) roll it between your hands for a minute or two... it warms up some.

    Option b) leave it out for a little while, then maybe roll it.

    If the pain from injecting cold insulin is the issue there are several options/possibilities. Not the least of which consider keeping it NOT in the fridge if where you live would permit it... meaning ie not Arizona, Nevada, places that get insanely HOT before the sun even comes up!!!

    Storing a single pen, a single vial (not the entire pack) will do no harm at all. Could that be A factor in this pain she is suffering... one of many potential explainations.

    If its truly a pain issue she can always smack HARD the part she's injecting into as if she were being bitten by huge mosquito. Then inject into that numbed spot (numbed the hard way)... (btw make suire SHE does the "smacking" she won't need that method for long)

    If the deeper issue is she does not want to do it... you took a GREAT approach. Make sure DAD (other adults in her life) buy a piece of this, so mom is NOT the "OGRE"... just one of many <ggg>.
    Last edited: Aug 5, 2011
  5. mom24grlz

    mom24grlz Approved members

    Mar 30, 2010
    hi is it the actual pen tip that hurts or is the insulin burning her. If it's the insulin you can try giving it to her at room temperature. When Ashleigh was on lantus she complained that it burned if she took it when it was cold. It wasn't so bad at room temp.

    If it's the actual needles, how about trying a different size? What size does she use now. I know a lot of kids prefer the smaller size 4mm or 5mm. However Ashleigh seemed to think the smaller ones hurt more. We tried a 5mm size and she hated them. She thought the 8mm ones hurt a lot less, so that's what we used. The pen tips we used were unifine pentips.

    Chris mom to 12 year old Type 1 daughter DX 3/23/10 pumping animas ping
  6. KRenee

    KRenee Approved members

    Jul 23, 2008
    Injections always hurt my daughter. All insulins, all needles, all devices, all temperatures...everything. Now that we are pumping we figured out that what was painful was the rather sudden injection of fluid. With the pump, boluses go in at a drip and don't hurt anymore.
  7. Denedil

    Denedil New Member

    Aug 3, 2011
    I'd try a longer needle if she's using a 4 or 5mm..... When I switched to Lantus (and was taking a rather large dose of it...) the 5mm would hurt, a lot, and leave "bumps" on my stomach. Heck I was 20 and feared the pain they use to give, so I understand your daughters not wanting to do it. By accident I started using 8mm needles, and all the pain went away, I havn't looked back since.

    (This is regarding BD Ultra-fine pen needles fyi..) All injections were done on the stomach.
  8. kinners

    kinners New Member

    Sep 27, 2011
    HI, Mrs. Becky! I have always found the insulin pens to be very painful as well.

    Has your child tried an auto-injector? That's what I use and they are basically pain free because they are spring loaded. An auto injector also enables you to reach more injection spots.

    Here's an example of one brand:


    I use one specifically for Monoject syringes. I believe BD has one as well.

  9. MomofSweetOne

    MomofSweetOne Approved members

    Aug 28, 2011
    We just switched to a pump from MDI, but my DD had definite opinions on how her insulin should be injected. She liked the Humalog Luxura cartridge pens but NOT the Humalog Kwikpen. She disliked the Lantus pen intensely, so we drew out of them with syringes. (One pen would last us a month until about 6 weeks ago.) The Lantus still hurt her, though. I don't miss the tears in her eyes or winces from the pain.

    When we trialed pumps, my DD rejected the Animas because she could feel even small boluses. She doesn't feel them at all with the Revel.

    So much of this is one's personal preference and finding what is the most bearable.
  10. TheFormerLantusFiend

    TheFormerLantusFiend Approved members

    Sep 10, 2006
    I found some of the pens more painful than others- in particular the NovoFlexPen was awful because of the amount of force.
    Also, shots done by my mother hurt more because she pinches and she presses the needle in too much.
    I really like the new 4mm pen needles that BD came out with a few months ago. They are also skinnier and they slip through my skin without a pinch or much force.
  11. Rich

    Rich New Member

    Mar 5, 2012
    Sometimes my injections are painful but most of the time it doesn't bother me at all. The only reason that I could think of as to why they're painful is because I may have had too many injections in that spot or close to it. I try to move it around to avoid this problem (though I can't be positive that this is the reason).
  12. peruvianpasohi

    peruvianpasohi Approved members

    Apr 20, 2010
    you could also get emla and numb the site first.

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