CDC and FDA: Don’t Share!

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It would seem to go without saying that devices used to puncture the skin — such as lancets and insulin pen needles — should never be shared by more than one person. In fact, these components are not officially considered reusable even by the same person, although as we noted in a previous post here at Diabetes Flashpoints, many people with diabetes reuse them anyway. But what about the reusable devices that these disposable components are paired with: lancing (fingerstick) devices and insulin pens? Can more than one person safely share them?

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) recently addressed this question as it relates to devices in health-care settings. In coordinated statements, the agencies announced their position that lancing devices should never be used to obtain a blood sample from more than one person. The FDA noted that there has been a constant increase in reported instances of bloodborne infections being transmitted in health-care settings over the last 10–15 years, particularly involving the hepatitis B virus. The agency blames, in part, unclear labeling of multiple-use lancing devices for this trend. It has not always been made clear, says the agency, whether a device was approved for use on multiple patients or simply for multiple uses on the same patient. Furthermore, cleaning and disinfection instructions for these devices may have been inadequate. Therefore, even for devices the FDA previously cleared for use on multiple patients, the agencies say this practice should be discontinued. They even recommend using devices that physically cannot be reused, such as those on which the lancing blade permanently retracts after one use.

But the agencies do not stop at lancing devices. They also recommend that, whenever possible, blood-reading devices (such as blood glucose meters and anticoagulation meters) should also be limited to one person. It appears that this recommendation is also based on infection fears, even though when they are properly used, nothing that enters these devices makes close contact again with the patient. But there is, of course, always potential for error in use, and the agencies apparently feel that limiting these devices to one person will reduce the infection risk posed by error enough to outweigh the inconvenience of this limitation.

What do you think — would you have been comfortable having a blood sample taken with a lancing device approved for, and used by, more than one patient? Have you ever shared a lancing device or an insulin pen with another person? In what, if any, situations would you be comfortable doing this? Is sharing a blood glucose meter more acceptable? Leave a comment below!

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