I Know About Needles



That is the first line of Andie Dominick’s 1998 memoir, also titled Needles, on growing up with type one diabetes. I read it when I was sixteen, after Googling “diabetes memoirs,” because I was the only person I knew with this disease, and I was lonely.

I, too, know about needles.

I know about the orange-capped syringes, how to hold the barrel up to the light, tap the tiny air bubbles to the top, push the plunger, squeeze them out. I know, from being a perfectionist, that sometimes no amount of flicking and tapping and cursing and squinting will release that last miniscule burst of air. I know it is not recommended to reuse these, but I also know that I’ve reused a syringe to the point of all numbers—the measurements—being worn off, to an unmarked barrel, eyeballing my dose. I’ve reused a syringe until its point grew dull, hard, a painful stab. I’ve reused a syringe until its fine needlepoint broke off just before entering my skin. (I don’t recommend this!) I know how frustrating it is to give a shot in a movie theater—fumbling in the dark for the supplies, waiting for the flash of the film’s bright light only to have timed it perfectly for film history’s longest ever cave scene, black as night.

With the exception of my freshman year of college, when I wore an Omnipod, I’ve always done MDI (multiple daily injections). Upon diagnosis, I was sent home with the syringes and the vials of insulin, but soon after, switched to Humalog and Lantus in pen form, which I still use to this day. Another type of needle.

I know that I prefer the BD Ultra-Fine Pen Needles in Short instead of Mini because in my mind, the Minis aren’t long enough to truly deliver the insulin into my body. (This is a completely made up notion. Like, completely. I recognize this, and yet, I still find myself ordering the Shorts.) I know that I still reuse pen needles for far too long, even after seeing a gross graphic of what a reused needle looks like—the fine point bent back, jagged, annihilated. I know to always dial 1 unit out as a test, to make sure it works. I’ve had the inner needle point bend, break, or be stopped up enough times to know this is necessary, as the doctors have said since day one. I know these bad boys give me a lot of bruises the size of quarters, in shades of indigo and violet, speckling my stomach and hips. Sometimes they hurt. I haven’t been able to find a pattern, specific spots to avoid. I know sometimes I hit a spot that sends blood dripping down my side, as I rush for a paper towel. This is when the bruise sets in. This is how more than a few t-shirts have become blood-stained.

And I know about some other kinds of needles: the finger prick, the lancet. Though, of course, I only see them during my bi-annual lancet change. (Kidding…) I know the winter months hurt more. I know, in any season, my ring fingers are tender, my thumbs pretty tough. Every one of my fingertips is  speckled with scars, though thanks to my Dexcom, less so.

And speaking of Dexcom, this needle hurts me the most. Maybe because I insert on my upper thighs, which has always made me cringe anyway. I avoid this spot for shots, but for my Dexcom, I find it most comfortable here, most out-of-the-way and still accurate. The insertion hurts, but the continuous glucose monitoring is worth it.

A friend once walked into the room where I was inserting a new Dexcom sensor, the plunger protruding from my leg, which is probably the most dramatic looking diabetes-thing I have, since I don’t have an insulin pump. What are you doing?! she asked, full of concern. I explained, and she watched. When we returned to the other room, full of our friends, she announced, Sarah just did some intense diabetes stuff that we all need to now acknowledge and congratulate her for!

I find unopened extra pen needles everywhere: zippered compartments of every purse, the car’s cup holder, my dresser drawers. My life is, in a word, sharp.

Every single day for twelve years now, my body has known a needle.

Or two needles, six needles, ten needles, depending. A cold, thin, silver bite, then on with it—the coffee, the weather, the laughter, the work—until the next one. And the next.

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Rick Phillips

Sarah, i recall using steel needles that one boiled between uses. Oh an the absolute rule? No oatmeal in the pan you boil needles in. We have to keep our needles clean. Those things were monsters.


I know too…and that part where your friend announced that you needed to be acknowledged made me tear up. She sounds like a keeper :)


Hi Sarah,
I enjoy reading your posts on the subject of diabetes. As a T1 of 54 years duration I can readily relate to most of what you write. Keep up the good work and good luck with your own journey. Take care, Daniel.


So well expressed. And cathartic to read thoughts I’ve had yet expressed by someone else!


Love your post, Sarah, I know too! I was diagnosed as a Type 1 at age 6, and it is 60 years now. Boiling glass syringes and steel needles was my start, then on to disposables, to pumps, and now pens.

Anne Armistead
Anne Armistead

Being type 2…I don’t know about needles. But you have graciously provided me with a slice of that reality and given me pause to be more thankful for all I have.


Great post :-) I know also

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