From the earliest days of insulin therapy, when glass syringes and needles had to be sterilized before use, to the modern era of insulin injector pens and easy-to-use, sterile, disposable needles, insulin delivery has come a long way.
Choosing the right insulin pen needle can make a big difference in the comfort and effectiveness of insulin injections for people with diabetes. However, with a variety of sizes, lengths, and gauges to choose from, it can be challenging to know which pen needle is the best fit for you.
Whether you are new to insulin therapy or looking to switch to a different type of needle, this guide is designed to help you understand the different kinds of insulin pen needles to make an informed decision.
Related article: Does Insulin Need to Be Refrigerated? How to Store it Correctly?
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What’s an Insulin Pen Needle?

An insulin pen needle is a small, disposable needle used to inject insulin from an insulin pen subcutaneously (under the skin). They are typically made of thin, high-quality stainless steel and coated with a special lubricant to reduce discomfort caused by insulin injection.
Insulin pen needles are single-use disposable needles designed to be used only once and disposed of in a sharps container. This helps to prevent the spread of bloodborne diseases and reduces the risk of accidental needlestick injuries.
Pen needles are available in various lengths, gauges, and thicknesses to accommodate different insulin pens, body types, and insulin delivery needs.
There are two different types: standard pen needles and safety needles.
Related article: A Step-by-Step Guide to Using an Insulin Pen!

Standard insulin pen needles

Standard insulin pen needles have a straight needle connected to the insulin pen. They are easy to use and can deliver insulin quickly and accurately. However, they do not have any built-in safety features to prevent needlestick injuries.
Examples of standard insulin pen needles:

Safety insulin pen needles

On the other hand, safety pen needles have retractable needles to reduce the risk of accidental needlestick injuries. After the injection, the needle retracts into the pen, preventing exposure to the tip and reducing the risk of accidental contamination.
Safety pen needles are available in various designs, including those that are manually retracted and those that automatically retract after injection. They are recommended for people who are at higher risk of accidental needlestick injuries, such as healthcare workers, diabetic children, or people who have poor eyesight or mobility issues.
While safety pen needles can be more expensive than standard insulin pen needles, they offer an added level of safety.
Examples of safety pen needles:

Related article: 10 Tips that Work for Injecting Insulin Without Pain!

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Insulin Needle Sizes

Insulin pen needles are available in different sizes, typically 4 mm to 8 mm long and 29 to 33 gauge thick.
The appropriate needle size for an individual depends on several factors, including the thickness of the subcutaneous tissue at the injection site, the type of insulin, and individual preferences.
Ultimately, the size of your insulin pen needles should be determined with the help of a healthcare provider to ensure accurate, safe, and comfortable insulin delivery.
Related article: Why and How to Prime Your Insulin Pen?

Needle length

Insulin pen needles are available in lengths ranging from 4 mm to 8 mm, with 5 mm and 6 mm being the most common.
Shorter needles (4-5 mm) are recommended for people with a low body mass index, children, and those who prefer a shorter needle. Longer needles (6-8 mm) are recommended for people with thicker subcutaneous tissue.
Other factors, like the injection site, can also influence the choice of insulin pen needle length. For example, shorter needles are generally recommended for injections into the abdomen or thigh, whereas longer needles may be necessary for injections into the buttocks.

Shorter needles also help minimize discomfort during the injection. Therefore, trying different needle lengths to determine which one works best for you is sometimes necessary.
Insulin needle length conversion (from mm to inch):

  • 4 mm = 5/32 inch
  • 5 mm = 3/16 inch
  • 6 mm = 15/64 inch
  • 8 mm = 5/16 inch

Needle gauge 

The gauge is also important to consider when choosing insulin pen needles. It refers to the needle thickness, with lower gauge numbers indicating a thicker needle.
Most insulin pen needles have a gauge of 31, 32, or 33. The appropriate gauge depends on several factors, including the type of insulin, the thickness of the subcutaneous tissue, as well as individual preferences.
Some types of insulin, such as concentrated insulin or insulin suspensions, may require a thicker needle to ensure that the insulin is delivered properly.
As for the needle length, it is essential to consult a healthcare provider to determine the appropriate insulin needle gauge. Trying different needle gauges to find out which works best for you may be helpful.

Related article: Clear vs. Cloudy Insulin, Why it Matters!

Insulin needle size chart

Here's an insulin needle size chart showing some general information about the most common insulin pen needles, including their length, gauge, and brand:

Brand Needle Length (mm) Needle Gauge
BD Nano 4 32
BD Ultra-Fine 4, 5, 6, 8 31, 32, 33
EasyTouch 4, 5, 6, 8 31, 32, 33
Clever Choice 4, 5, 6, 8 31, 32, 33
NovoFine 4, 6, 8 30, 32, 33
NovoTwist 5, 6 32
Owen Mumford 4, 5, 6, 8 31, 32, 33
UltiCare 4, 5, 6, 8 29, 30, 31, 32, 33

Please note that this chart is not an exhaustive list of all insulin pen needles available and that different brands may have different specifications.
Related article: How to Keep Insulin Cool While Traveling?

More Features to Look for When Choosing Insulin Pen Needles

Besides length and gauge, there are several other features to consider when choosing insulin pen needles, including:

Needle type

As mentioned above, there are two types of insulin pen needles - standard and safety. Standard insulin pen needles have a straight needle attached to the pen. In contrast, safety insulin pen needles have retractable needles designed to reduce the risk of accidental needlestick injuries.

Insulin pen and needle compatibility

Needles are generally not included in insulin pen packages, so you need to purchase them separately. Fortunately, most brands of pen needles fit any of the insulin pens, including the Lantus Solostar pen, Levemir Flextouch pen, Novolog Flexpen, Humalog Kwikpen, Fiasp, and others.

However, there are a few exceptions with particular needles that were designed to fit specific types of pens, like the Novotwist needles from Novo Nordisk (discontinued). So, make sure to select needles that are compatible with the specific model of your insulin pen. Besides, insulin pen manufacturers often offer their own line of needles, which are designed to work seamlessly with their pens.
Using an incompatible needle may result in inaccurate insulin dosing or leakage. Always check the manufacturer's instructions and ask your doctor or pharmacist if you need clarification on which insulin needles are compatible with your pen.
Related article: What Are Smart Insulin Pens and Are They Really Worth it?

Coatings and lubricants

Insulin pen needles are available in various coatings and lubricants that can reduce pain and discomfort during injection.
Some needles have a silicone coating that can make the injection less painful, while others have a special lubricant that can reduce the friction between the needle and the skin.

Related article: How to Calculate Your Insulin Dose Correctly?

Needle tips

There are two main types of insulin needle tips: beveled and non-beveled.
Beveled insulin needles have slanted tips to minimize discomfort and pain during injection. The angle allows the needle to penetrate the skin more easily, reducing the risk of pain or bruising. This type of needle tip is commonly used in insulin pen needles and syringes.
Non-beveled insulin needles have a flat, straight tip that is designed to minimize the risk of skin damage or injury. They are typically used in insulin pump infusion sets, which deliver insulin continuously.
Related article: What Happens if You Miss a Dose of Insulin?

Insulin needle costs

The cost of insulin pen needles can vary depending on the brand and type. Someone with insulin-dependent diabetes can use up to 6 insulin pen needles daily, so the cost can quickly add up!
Standard insulin pen needles can cost anything from $4 to $10 per 100-count box.

Related article: How to Fix a Jammed Insulin Pen?

Insulin Pen Needles: Frequently Asked Questions

What are the best insulin pen needles?

Some of the best insulin pen needles include:

  • BD Ultra-Fine
  • BD Nano 4 mm
  • BD Nano 2nd Gen Pen needles
  • BD Autoshield Duo safety needles
  • Owen Mumford Unifine Pentips Plus
  • Owen Mumford Safe Control safety needles
  • NovoFine 31G insulin needles
  • NovoFine Autocover safety needles

Lesser-known brands of insulin needles also offer great choices, often at a lower price, such as Easy Touch, Care Touch, TruePLUS, MedTfine, or ComfortEZ.

What are the smallest insulin needles?

The smallest insulin needles available on the market are 4mm long and have a gauge of 32 or 32, like the BD Nano 4mm or the NovoFine.
These shorter and thinner needles are designed to provide a more comfortable and less painful insulin injection. However, they may not suit every patient with diabetes.
Ask your healthcare provider to determine which needle length and gauge are best for you based on your individual needs and preferences.

How to use an insulin needle?

Here are the steps to safely use an insulin pen needle:

  1. Wash your hands.
  2. Prepare your supplies for insulin injection (insulin pen, needle, sharps disposal, alcohol swab, glucose meter, etc.).
  3. Clean the injection site.
  4. Remove the insulin pen cap.
  5. Pull the paper tab off the needle.
  6. Screw the needle onto the rubber seal of the pen.
  7. Remove the outer needle cap and keep it on the side for later use.
  8. Remove the inner needle cap.
  9. Inject the insulin.
  10. Place the outer needle cap back on.
  11. Unscrew the needle from the pen.
  12. Dispose of the needle in a sharps container.
  13. Recap the insulin pen. 

Related article: How to Read Insulin Syringes and Get the Right Dose?

How many times can you use an insulin pen needle?

Insulin pen needles are designed for single use only, meaning they should be used for one injection and immediately disposed of.
Reusing insulin pen needles can increase the risk of infection, affect insulin dosing accuracy, and cause pain or discomfort during injection.
Therefore, you should use a new, sterile needle for each injection.

How to dispose of pen needles?

Insulin pen needles are sharps. Therefore, they should be disposed of safely and responsibly to prevent injury and infection to yourself and others. Here are some steps to properly dispose of used insulin pen needles:

  • After use, remove the needle from the insulin pen and place the pen cap back on the pen. 
  • Carefully insert the needle into a sharps container. Sharps containers can be obtained from your healthcare provider, pharmacy, or medical supply store. 
  • If you do not have a sharps container, use a puncture-resistant container with a tight-fitting lid, such as a plastic detergent bottle or a metal coffee can.
  • Once the container is full, seal it tightly with the lid and label it "Sharps" or "Biohazard."
  • Do not throw the container in the household trash. Instead, ask your local waste management agency about sharps disposal collection sites like doctor’s offices, hospitals, pharmacies, medical waste facilities, police stations, or other places.

Related article: How to Dispose of Insulin Needles, Syringes, Pens, and Vials Safely?

Do pen needles require a prescription?

No. You don’t need a medical prescription to buy insulin pen needles in the United States. They’re available off-the-counter and can be purchased in pharmacies or online.
However, your health insurance may require a prescription to cover the cost of insulin pen needles.

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What about you? Do you use insulin pens or syringes? What are your favorite pen needles?

March 31, 2023

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