Fear of Needles and Diabetes

Patient Expert
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If you are afraid of needles, you are not alone. More people have what is called needle phobia than have diabetes. At least 10 percent of us have needle phobia, according to Dr. James Hamilton's ground-breaking article, "Needle Phobia: A Neglected Diagnosis, in the Journal of Family Practice". About 9.3 percent of Americans have diabetes, according to the U.S. Centers for Disease Control and Prevention's most recent count.

If you have type 1 diabetes, you take your insulin injections or else. Almost all type 1's overcome their fear of needles. But, as Dr. Hamilton says, occasionally needle phobia can be fatal.

If you have type 2 diabetes, you won't die if you forego injections. But you may well get sicker. While 39 percent of all type 2's older than 18 use insulin, more would benefit from it if they weren't afraid of the shots. Between needle phobia and the belief that insulin therapy is a last resort when orals fail, many type 2's aren't getting the control we can and should have.

Many people, especially when starting out on insulin, feel afraid of injecting themselves. Yesterday, as I prepared to take my morning shot in my stomach, I reflected on the reluctance I originally had. I know that it was totally irrational, because I had seen my wife shooting up insulin without flinching. I knew too that there are almost no nerve endings in the stomach, so we hardly feel the shot. Any reluctance to do fingerstick tests is a lot more rational. That's one reason why alternative site testing generally makes a lot of sense.

Needle phobia isn't always rational. It often starts in childhood, when you receive vaccines and other injections with what look like horse needles. Nowadays, the needles that people with diabetes use for their injections of insulin are much thinner and shorter. Modern 31 gauge needles are so thin, in fact, that I can't see them without my glasses. They are much shorter too, just 3/16" of an inch long.

It helps to see someone else inject herself or himself, as I watched my wife. Pricking your finger with a lancet is, of course, much more painful. I would have been much more reluctant to start testing my blood glucose 12 years ago if the pharmacist hadn't showed me by pricking her own finger.

Strangely, as common as needle phobia is there are few studies of the condition. I searched the professional literature with PubMed using MeSH, the National Library of Medicine's controlled vocabulary used for indexing articles for MEDLINE/PubMed. The relevant terms are phobic disorders AND needles. There are only 38 citations.

By comparison, PubMed has 214,594 MeSH citations for diabetes mellitus. At least we know a lot more about it. But if you have both conditions, you've got a problem. Since there is no cure yet for diabetes, you need to find a cure for your needle phobia.