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September 20, 2006

Insulin

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Question from Elkins, West Virginia, USA:

Is it necessary to wipe the top of insulin vials each time with alcohol wipes before drawing up the insulin?

Answer:

From: DTeam Staff

There are a lot of things that people are doing now that are not recommended by anyone. Issues such as reusing old syringes, preparation of the skin, mixing of insulin, and additional such issues make a uniform policy difficult to agree on. However, I think it should be understood that good sterile technique is at the center of good clinical care. You may not have to use alcohol on the insulin vial or on the skin if, each time, you use a new, sterile syringe and needle. For those who reuse syringes, it is very important to use alcohol on the vial. You could potentially acquire bacteria from the skin and then contaminate the vial with reuse. Insulin has a bacteriostatic additive that prevents bacterial overgrowth. You can detect it as the medicinal smell you have with insulin. However, it is possible to contaminate the insulin with previously used syringes. This makes it likely that you are injecting bacteria into the subcutaneous space and this could cause infection. Finally, it should be pointed out that the reuse of insulin syringes is not a recommended procedure.

JTL

[Editor’s comment: We received several answers from our team members about this. Some say you should wipe the vial, while others deem it unnecessary. Dr. Lane’s answer is the most thorough.

BH]