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Administrating Insulin and Insulin Analogues

Dealing with Needle Phobia

What is a Phobia?

Needle phobiaA phobia is an irrational fear of a particular situation, which is exaggerated and cannot usually be explained away. Fear of heights, fear of public speaking and fear of dentists are some phobias encountered among people.

Needle phobia is therefore a fear of needles. A small degree of dislike of needles is normal – most people would avoid them if they could. This fear is heightened in people with needle phobia, to the point where they cannot bear the thought of injections. Overall, up to 10% of the population may be affected to a certain degree.

Why is this a problem in diabetes?

In people with diabetes, who need regular injections of insulin needle phobia can pose a real difficulty. They find themselves in the situation of having to have injections to control their blood sugars and stay healthy, but spending their time dreading the next jab. Needle phobia is of particular importance in diabetes, as insulin cannot be given in tablet form as it is broken down in the digestive system. Often, the injections need to be given several times a day.

What causes needle phobia?

Nobody is entirely sure what causes a phobia. Of course, phobias of snakes and heights may make more sense as these may be dangerous. Even though you know deep down that the phobic situation is not going to harm you it is often difficult to explain it away.

Some people think that needle phobias may have resulted from a previous unpleasant experience – for example having a painful injection as a child. Some suggest that people with needle phobia may be more sensitive to pain during injections than others. Many children are needle phobic probably as a combination of the fear of the strange environment at a clinic or hospital, couple with the pain of the injection.

What are the symptoms of needle phobia?

The symptoms can be very variable. The main feature is anxiety at the thought of injections and avoidance of injections. This may be associated with your mouth going dry, palpitations, sweating, trembling, over-breathing, feeling dizzy and light-headed, feeling sick and even fainting.

What can I do to reduce needle phobia?

If you, or someone you know are needle phobic, the best thing is to be open about this to the doctors and nurses who are treating you. They will be able to talk through the problem with you and suggest methods for overcoming the problem. They may in some instances be able to find an alternative treatment. If your symptoms are mild they usually settle without much difficulty.  More severe phobias may require the involvement of specialists who are used to treating these conditions.

The use of topical creams, which contain local anaesthetic agents to reduce pain sensation is often helpful to reduce pain associated with injections.

Are there any options to using needles for insulin injections?

Developments in injection technology have produced very fine needles which bear no resemblance to the large needles used for drawing blood which people often visualise when contemplating having an injection.

Alternative methods of insulin delivery are currently being explored. One such method is to use a high pressured jet of air to force the insulin through the skin without the use of needles. Other approaches include the use of insulin inhalers.

 

Author: Dr Stephen Wallis
West Suffolk Diabetes Service
September 2003