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Needle phobia

If your fear of needles is getting in the way of managing your type 1, we’ve got help and advice to help you overcome your anxiety.
Content last reviewed and updated: 25.04.2024

Jharna injecting insulin in a meadow

What is needle phobia? 

It’s estimated that needle phobia affects 1 in 10 people so if you feel this way you’re not alone.   

It’s normal to dislike needles, but a fear or dislike becomes a phobia when it leads to problems. For example, if a fear of needles stops you from injecting the insulin you need it might affect how you manage your type 1 diabetes.  

What are the signs of needle phobia?  

When you have a needle phobia, coming into contact with a needle may cause you to feel: 

  • Scared 
  • Tearful 
  • Hostile or agitated 
  • Dizzy or faint 
  • Like you want to run away 

How can needle phobia affect type 1 management?  

A lot of people don’t like injections, but when you have type 1 it’s difficult to avoid them. There are needles in injection pens, finger prickers used with blood glucose meters, glucose sensors, as well as the cannulas used with insulin pumps. This mean that needles are a part of everyday life with type 1. There will be needles at your regular blood tests to check your HbA1c, which is an important measurement of your glucose levels over time. You’ll also need to get vaccinations to protect you against illnesses like flu and covid. 

If you have a phobia of needles, you might start avoiding them. This might stop you getting the insulin that you need.  

Is it possible to manage type 1 if you have needle phobia? 

You can still manage type 1 if you have needle phobia, you might have to do things a little differently. 

You can take steps to overcome your phobia (see below) and put strategies in place. This might be: 

  • Getting someone else to help you inject 
  • Finding ways to prepare mentally and emotionally for injections  
  • Having a special routine around injections that makes you feel more comfortable 

How can I try and overcome my needle phobia?  

Here are some tips to help you relax around needles. Everyone is different, so you may want to try a few of these techniques to see what works for you. 

Relaxation 

Take slow deep breaths into your belly. This can help to relax your body and stop the release of stress hormones.  

Some people find it helps to tense their muscles as hard as they can and then relax them a few times. 

Listen to a playlist of relaxing music or a guided mediation before and/or during the injection.  

Distract yourself 

If your mind is caught up with anxious thoughts, try giving it something else to focus on, such as:  

  • Focusing on the other parts of your body (e.g. by focussing on what your clothes feel like or fiddling with your watch) 
  • Thinking or talking about something positive (like holidays) 
  • Looking at something on your phone, playing a game, listening to music or reading 
  • Thinking of a list of things that start with every letter of the alphabet. For example, an animals list would start Aardvark, Bee, Caterpillar… 

Keep things sharp 

The needle tops for your insulin pens are single use and should be changed every time you use them. It’s the same for the lancets in your blood testing kit.

If you don’t change them regularly it’s likely that they will become blunt. This could cause you unnecessary discomfort. It might also put you a risk of developing lumps under the skin that can stop your insulin working properly. 

Feeling faint 

If you’ve got needle phobia, you may feel faint during an injection or insertion. The fear of fainting during an injection can add to your overall worries. 

You can try lying down with your feet up whilst you inject. This can help stop the blood rushing to your legs and feet and making you feel faint. You can also try crossing your legs and clenching hard (like you’re desperate for the toilet). 

Tackling your phobia one step at a time 

One way to overcome phobias is to break them down into little steps that you overcome one at a time. You can use a technique called the fear ladder to help you work through this.  

Think of ten situations involving needles. Give each one a mark out of ten for how anxious each one makes you feel, with 10 causing the most anxiety and one causing the least. For example, you might give a mark of one out of ten for a picture of a needle, and ten out of ten for having a blood test.  

Start at the situation with the lowest mark, for example the picture of the needle. Look at it over and over again until you are completely bored with it. 

When you’ve done this you can give yourself a reward and move up to the next level. 

Things at the top of your fear ladder may feel completely unreachable right now. Working your way up gradually will help it feel more achievable. 

Heading: Example fear ladder

Work your way up the ladder from 1 , doing each step until you are comfortable with it. Choose a treat to reward yourself every time you complete a step.

Picture: A drawing of a grey ladder. Each step is numbered 1 – 10 from the bottom of the ladder upwards.

There is text on each step which has something to do to help you overcome a fear of needles.

Look at a picture of a needle

Look at a needle on the table in front of you

Watch a video online of someone getting a successful injection 

Watch someone else getting an injection

Hold a needle in your hand

Inject something like a stress ball or an orange - or Rufus

Sit in the phlebotomy chair at the GP surgery

Let the nurse hold the needle next to your skin

Have an injection

Have a blood test and celebrate overcoming your phobia!

Find out more about using the fear ladder in Talking Type 1’s Not OK with Needles workbook. 

Use type 1 technology 

Type 1 diabetes technology doesn’t replace needles or finger pricks, but using continuous glucose monitors (CGMs) and insulin pumps can reduce how often you encounter them.  

A CGM is worn on the upper arm with a small wire that goes under the skin. You change the sensor every six to 14 days (depending on the type of CGM that you have). 

Micro or patch insulin pumps are stuck directly onto the skin. They need to be changed around every three days. 

Tethered pumps attach to you through a tube, cannula and/or needle (known as infusion sets). The needle is taken away once the cannula is in place and the cannula needs to be changed every two to three days. There is usually a choice of infusion sets, so talk to your Diabetes Healthcare Team about what might work for you. 

Learn more about CGMs, insulin pumps and what is available on the NHS in our Guide to Type 1 Technology. 

Products that can help 

Tickleflex is an accessory that you can attach to the end of your insulin pen. It makes injecting more comfortable and consistent. 

i-Ports are small injection ports that you wear for up to three days. It means that you only puncture your skin when you apply the port instead of for each injection. You can wear an i-port during normal activities like sleeping, bathing and exercising. 

Where can I find support?  

If you’re struggling with needle phobia, speak to your Diabetes Healthcare Team. They may be able to work through techniques with you or refer you to a psychologist. 

You can find information and activities to help you work through needle phobia in the Talking Type 1’s Not OK with Needles workbook. 

There is also information and advice about needle phobia on Anxiety UK and Guy’s and St Thomas’ Hospital Needle phobia and overcoming your fear page.

This content was developed from Talking Type 1’s Not OK with Needles workbook, written by Dr Rose Stewart in collaboration with people living with diabetes and NHS diabetes healthcare professionals.