# “People with diabetes shouldn’t inject insulin publicly!” **URL:** \ **Category:** The BBQ Pit\ **Created:** [May 10, 2005, 4:45pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240 "2005-05-10T16:45:32Z")\ **Posts on this page:** 20\ **Page:** 14
**Author:** ![eleanorigby](https://avatars.discourse-cdn.com/v4/letter/e/ee7513/32.png) [@eleanorigby](https://boards.straightdope.com/u/eleanorigby)\ **Post date:** [May 12, 2005, 3:15pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/261 "2005-05-12T15:15:17Z")
My point is that the mix of bacteria in a public toilet is one that might boggle the mind. I am sorry that I do not have data for you as to the number and variety of germs–do you not think they are present? SD did a column on the cleanliness of public bathrooms awhile back. If I ever figure out how to link, I will. I doubt that a study has ever been done that looks at injection infections: restaurant setting or lavatory setting, but seems anyone can get a grant these days… 🙂 Probably extraneous background info, but it makes me feel better posting it: In nursing (and in health class, really) there are sterile things, clean things, and soiled/contaminated/dirty things. Your actions with each depends on the task involved and the risks to the pt. Example: patient has 3 or 4 deep, open, infected wounds. You use clean technique(gloves) to remove the old dressing on wound #1. You then use sterile technique to reapply a new dressing. But you do not go straight from wound to the next. Even though the wounds are on the same pt (and most likely share “his” germs) you still handwash, don new nonsterile gloves to remove the next open wound’s dressing. And yet again for the third-IOW, you treat each wound as a separate entity. Lots of time and lots of gloves. This applies to dressings done at the bedside. I am not speaking of OR stuff (any OR nurses here/). We are taught (Ha! more like drilled so that girls used to wake up crying out, “I’m sterile, I’m sterile!” during their OR rotations. It was as funny then as it is now) to respect the differences and act accordingly-in all aspects of care. Hence, as a nurse, I would never use the same measuring graduate to empty a Foley (bladder catheter) and also a wound drain. The risk of cross contamination, while it might be small, is present. Why take it? In the hospital, we don’t prep meds in the patients toilet–it is considered a dirty area, and it IS dirty. Why would a public toilet be any different? **Hentor** has already addressed the common of a decent, DRY surface on which to place the kit. That alone is reason not to use the bathroom for this purpose. Alot of germs are spread via contact. You put the kit on a wet sink ledge, then pick the kit back up–the germs are carried on the kit and are now on your hands etc. Why go there? Why introduce the possibility, however small? If someone HAD no choice but to use a toilet for injecting, I would reccomend that 1. wash your hands 2. wipe down with a dry paper towel the area around the sink. 3. discard paper towel. 4. wash your hands again, using a paper towel to turn off the faucet. 5. place a few layers of paper towels next to the sink-you are creating a “clean” field. 6. put the kit on the paper towels. 7. wash your hands again. 8. test blood sugar 9. prep injection. 10. wash your hands again, if you feel that you might have touched something during the above process that may have contaminated you. 11. inject insulin. 12. zip up kit, after disposing of sharp appropriately. 13. clean up area. 14. wash your hands again\*. Leave the restroom It may sound OCD, but it’s not-it’s being careful and cautious. I do not know if diabetics do all this–I doubt it; most probably wash their hands using hand gel and do this at the table, which provides a clean, DRY surface for the kit. Simpler, easier and faster. \*if, for some strange reason, I were to be the one injecting YOU in a public restroom, this is what I would do–it’s quicker than it looks, because it is second nature to me now. If I had clean gloves, I would not do #7 or #10, unless I had contaminated the gloves somehow. Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is. ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [May 12, 2005, 3:37pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/262 "2005-05-12T15:37:46Z")
> [@eleanorigby](#): > > My point is that the mix of bacteria in a public toilet is one that might boggle the mind. I am sorry that I do not have data for you as to the number and variety of germs–do you not think they are present? No, I absolutely believe those germs are present; I’m just not sure how they’d get onto the needle. Does the diabetic’s hands touch the needle at any point? I was under the perception (quite possibly incorrect) that the sterile needle was covered until seconds before the injection, that the only solid it touched was at the point of the injection, and that there would be very little opportunity for any bacteria to contaminate any part of the process except by settling on the skin at the injection site. Bacteria that were so settled would remain there even after the person returned from the restroom, such that injecting at the table afterwards wouldn’t reduce the risk of contamination. > [@](#): > > Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is. Not school marm-ish at all. You’re a nurse, and I’m not, so of course you know more about the process than I do. I’m just wondering how the bacteria in a restroom would manage to contaminate the process. Your examples seem to describe how a contaminated solid should never touch a wound, or touch something that would cause a wound. Does anything, contaminated or not, ever touch the needle pre-injection? Daniel ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [May 12, 2005, 3:46pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/263 "2005-05-12T15:46:38Z")
> [@Left Hand of Dorkness](#): > > Does anything, contaminated or not, ever touch the needle pre-injection? > > Daniel It shouldn’t, and I would probably just use a new syringe if it did. The syringe is firmly capped until you have to draw up the insulin. So the needle does touch the material covering the insulin bottle. One presumes that this is clean enough. After drawing the insulin, we almost always cap the syringe, because it is usually coming from the fridge, so we have to warm it between our fingers for a few seconds or it is more painful. When we are out, this is less of a requirement, and we may be more likely to go from having drawn it up to giving it immediately. The exposure to air of the needle should be thus fairly limited, and the only surface that it should touch prior to skin is the top of the insulin bottle. ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [May 12, 2005, 4:05pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/264 "2005-05-12T16:05:41Z")
> [@swampbear](#): > > Oh, and **Una** the bolded part of your quote? Thanks for adding to the list of reasons why I fear airplane toilets. :eek: The worst ever is coach class toilets on overseas flights - especially loooooong overseas flights, with LOTS of kids on the plane. I think after about 6-8 hours many parents just give up and decide to let the children regress to the level of barely trained gibbons, where everything in the loo - and I do mean EVERYTHING - becomes a new toy of infinite wonder and discovery. I’ve been on flights with a quarter-inch of “liquid” sloshing around on the matting, and “stuff” smeared like fingerpaints on the walls, handles… No way do I use those for a shot. No fucking way. ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [May 12, 2005, 5:38pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/265 "2005-05-12T17:38:54Z")
> [@milroyj](#): > > Really? I’m surprised. From your posts, it seems like disrobing your child in a restaurant would be perfectly acceptable to you. Or do you just save that particular performance for special occasions, say birthday parties, 1st communions, and Christmas? :dubious: **milroyj** , quit being a jerk. This is the fifth warning for you. I am going to discuss this with the moderation staff. Lynn For the Straight Dope ---
**Author:** ![swampbear](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/swampbear/32/467_2.png) [@swampbear](https://boards.straightdope.com/u/swampbear)\ **Post date:** [May 12, 2005, 5:54pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/266 "2005-05-12T17:54:38Z")
> [@Una Persson](#): > > The worst ever is coach class toilets on overseas flights - especially loooooong overseas flights, with LOTS of kids on the plane. I think after about 6-8 hours many parents just give up and decide to let the children regress to the level of barely trained gibbons, where everything in the loo - and I do mean EVERYTHING - becomes a new toy of infinite wonder and discovery. I’ve been on flights with a quarter-inch of “liquid” sloshing around on the matting, and “stuff” smeared like fingerpaints on the walls, handles… > > No way do I use those for a shot. No fucking way. AWW GEEZ! Are you just trying to torture me! I have to fly across country Saturday morning. I may not drink or eat anything at all from now til then. :eek: Regress to the level of barely trained gibbons… now that’s comedy gold! ---
**Author:** ![Lynn\_Bodoni](https://avatars.discourse-cdn.com/v4/letter/l/e47c2d/32.png) [@Lynn\_Bodoni](https://boards.straightdope.com/u/Lynn_Bodoni)\ **Post date:** [May 12, 2005, 5:55pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/267 "2005-05-12T17:55:59Z")
> [@](#): > > Diabetics are at higher risk for all infections, and caution is the watchword. Sorry to sound school marm-ish, but there it is. And not only are we at higher risk, we tend to heal more slowly when we get infected. Infections also tend to raise blood sugar levels, adding yet another complication to our lives. A couple of years ago, I had a major abcess/boil in my right arm. The swelling was the size of a grapefruit. From start to finish, I think that I spent about four months trying to get that thing healed, including some time in the hospital. I had several courses of oral antibiotics and a few different kinds of IV antibiotics. I developed an allergy to another antibiotic. I had to have a home health nurse come out to my house for a few weeks to give me antibiotics by IV after I was released from the hospital. All told, I think that my out of pocket expenses for that abcess totalled at least $5000…this isn’t including what my insurance paid out. I would really, really prefer not to go through that again. It wasn’t fun. I will do my best to avoid any germs I can. ---
**Author:** ![eleanorigby](https://avatars.discourse-cdn.com/v4/letter/e/ee7513/32.png) [@eleanorigby](https://boards.straightdope.com/u/eleanorigby)\ **Post date:** [May 12, 2005, 6:52pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/268 "2005-05-12T18:52:03Z")
> [@Left Hand of Dorkness](#): > > No, I absolutely believe those germs are present; I’m just not sure how they’d get onto the needle. Does the diabetic’s hands touch the needle at any point? I was under the perception (quite possibly incorrect) that the sterile needle was covered until seconds before the injection, that the only solid it touched was at the point of the injection, and that there would be very little opportunity for any bacteria to contaminate any part of the process except by settling on the skin at the injection site. Bacteria that were so settled would remain there even after the person returned from the restroom, such that injecting at the table afterwards wouldn’t reduce the risk of contamination. Well, those germs most likely don’t get onto the needle. But people drop things or miscalculate where the counter/table is and knock stuff off etc. Excluding the lavatory as a possible place is just increasing the safety net for a good, clean injection–in an injection, only the needle and the insulin are sterile. If **Hentor** was to fumble with the bottle of insulin at the table, chances are it will fall either in his lap or on the table(and it wouldn’t break). Not so in the toilet-where the tile floor would break the glass vial. If he dropped the syringe, chances are he would disspose of that one, and get a new one-I wouldn’t use a syringe that had dropped on a bathroom floor, no matter if it was capped-but I could see using a needle(capped) that fell onto a clean, dry tablecloth. Hope that helps, you **Daniel**. 🙂 So, really, using the “clean” environment of the table just eliminates potential problems–both physical and emotional. Except for those souls who are rocked to the core by the sight of a father taking care of his son. Perhaps this thread has given them food for thought and now they will volunteer to clean all the public restrooms wherever they dine out. 🆒 **Lynn** --you bring up very valid points. I was going to, but hesitated after the strawman/drama queen tactics. It only makes sense to eliminate as many potential problems that one can. Noone expects a bad asthmatic to sit in the smoking section–why do we expect diabetics to increase their exposure to hazards? I hafta work tomorrow, but already feel like I did a shift! 😉 ---
**Author:** ![Larry\_Mudd](https://avatars.discourse-cdn.com/v4/letter/l/f14d63/32.png) [@Larry\_Mudd](https://boards.straightdope.com/u/Larry_Mudd)\ **Post date:** [May 12, 2005, 7:46pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/269 "2005-05-12T19:46:12Z")
> [@Fear Itself](#): > > Some people are obsessed with restroom germs […] I’ve always wanted to ask them where they keep their toothbrushes. In the medicine cabinet, for the last six years. Why was that again? Oh, [right](http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050512/SPILL12/TPNational/Toronto): > [@Cecil Adams](#): > > Take it from me, if you do nothing else, put your toothbrush back in the medicine cabinet after use. ---
**Author:** ![Larry\_Mudd](https://avatars.discourse-cdn.com/v4/letter/l/f14d63/32.png) [@Larry\_Mudd](https://boards.straightdope.com/u/Larry_Mudd)\ **Post date:** [May 12, 2005, 7:49pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/270 "2005-05-12T19:49:03Z")
Whoopsie. Don’t know how that happened. [Corrected link](http://www.straightdope.com/classics/a990416.html). ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [May 12, 2005, 8:08pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/271 "2005-05-12T20:08:26Z")
> [@eleanorigby](#): > > Well, those germs most likely don’t get onto the needle. But people drop things or miscalculate where the counter/table is and knock stuff off etc. Excluding the lavatory as a possible place is just increasing the safety net for a good, clean injection–in an injection, only the needle and the insulin are sterile. If **Hentor** was to fumble with the bottle of insulin at the table, chances are it will fall either in his lap or on the table(and it wouldn’t break). Not so in the toilet-where the tile floor would break the glass vial. If he dropped the syringe, chances are he would disspose of that one, and get a new one-I wouldn’t use a syringe that had dropped on a bathroom floor, no matter if it was capped-but I could see using a needle(capped) that fell onto a clean, dry tablecloth. Hope that helps, you **Daniel**. 🙂 It does; my curiosity on the subject is satisfied, and I agree that doing theses shots in the bathroom seems like a bad idea for sanitary reasons. Thanks for being patient with me! Daniel ---
**Author:** ![Left\_Hand\_of\_Dorkness](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/left_hand_of_dorkness/32/7156_2.png) [@Left\_Hand\_of\_Dorkness](https://boards.straightdope.com/u/Left_Hand_of_Dorkness)\ **Post date:** [May 12, 2005, 8:10pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/272 "2005-05-12T20:10:03Z")
> [@Left Hand of Dorkness](#): > > doing theses shots “Dude, gimme another hit off that _Sociopolitical Analysis of late-20th-Century Capitalism in post-Keynesian Lithuania!_” Daniel ---
**Author:** ![Caricci](https://avatars.discourse-cdn.com/v4/letter/c/85f322/32.png) [@Caricci](https://boards.straightdope.com/u/Caricci)\ **Post date:** [May 12, 2005, 8:16pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/273 "2005-05-12T20:16:10Z")
> [@MGibson](#): > > A hearty fuck you right back at’cha for being so inconsiderate of everyone else at the restaurant. I can’t say I’m revolted by the idea of someone injecting a needle into their body but it’s certainly an unusual site and there are some who are really squeamish about such things. Is it really so hard to use the needles elsewhere? If not the bathroom then why not the car before entering the restaurant or is this kind of thing so time sensitive that you’ve got to do it moments before eating? > Marc I see this is a huge thread and I’ve only just gotten started so forgive if I’m being redundant in my comment but I just want to say that, for the most part, unless other diners are totally minding business other than their own, there is no reason to even notice. My sister has to inject pretty much while the food is in front of her (because, God forbid she should watch her diet - but that’s another story) and is able to do it so quickly and matter of factly that I’ve never actually caught her doing it and I’m right at the table with her. She injects insulin into her abdomen. It’s like a little magic trick almost! Same goes for the blood testing which is done in her finger. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [May 12, 2005, 8:32pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/274 "2005-05-12T20:32:26Z")
> [@Larry Mudd](#): > > In the medicine cabinet, for the last six years. > > Why was that again? Oh, [right](http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20050512/SPILL12/TPNational/Toronto): Yeah, I remember that one. Especially this part: > [@](#): > > As Professor Gerba’s research would later determine, however, **the bathroom was hardly the most dangerous part of the house** , microbe-wise. The real pesthole: the kitchen sponge or dishcloth, where fecal coliform bacteria from raw meat and such could fester in a damp, nurturing (for a germ) environment. Next came the kitchen sink, the bathroom sink, and the kitchen faucet handle. **The toilet seat was the least contaminated of 15 household locales studied.** “If an alien came from space and studied the bacterial counts,” the professor says, “he probably would conclude he should wash his hands in your toilet and crap in your sink.” So where do you prepare your food, again? ---
**Author:** ![Cagey\_Drifter](https://avatars.discourse-cdn.com/v4/letter/c/b2d939/32.png) [@Cagey\_Drifter](https://boards.straightdope.com/u/Cagey_Drifter)\ **Post date:** [May 12, 2005, 8:49pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/275 "2005-05-12T20:49:48Z")
I just have one thing to say: I hope that our society will someday evolve to a state where a man’s welfare will be considered more important than cosmetic appearances and other such selfish concerns. ---
**Author:** ![Troy\_McClure\_SF](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/troy_mcclure_sf/32/4150_2.png) [@Troy\_McClure\_SF](https://boards.straightdope.com/u/Troy_McClure_SF)\ **Post date:** [May 12, 2005, 9:07pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/276 "2005-05-12T21:07:02Z")
> [@Cagey Drifter](#): > > I hope that our society will someday evolve to a state where a man’s welfare will be considered more important than cosmetic appearances and other such selfish concerns. Amen. I consider “Miss Manners” and her ilk to be trolls of humanity. ---
**Author:** ![Cagey\_Drifter](https://avatars.discourse-cdn.com/v4/letter/c/b2d939/32.png) [@Cagey\_Drifter](https://boards.straightdope.com/u/Cagey_Drifter)\ **Post date:** [May 12, 2005, 9:26pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/277 "2005-05-12T21:26:20Z")
> [@Troy McClure SF](#): > > Amen. I consider “Miss Manners” and her ilk to be trolls of humanity. I’ll never forget the day 7 years ago I saw a sign declaring “no sleeping on stairs” next to a church staircase. still, so many years later, it rings so symbolic to me. [I Thank God there are some compassionate people out there](http://sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2005/03/27/ING8MBSSIB35.DTL) ---
**Author:** ![Oy](https://avatars.discourse-cdn.com/v4/letter/o/bc8723/32.png) [@Oy](https://boards.straightdope.com/u/Oy)\ **Post date:** [May 12, 2005, 9:49pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/278 "2005-05-12T21:49:26Z")
> [@Troy McClure SF](#): > > Amen. I consider “Miss Manners” and her ilk to be trolls of humanity. If you were to actually check out Miss Manners (can’t speak to her ilk - does she have any?), you would find that she never, ever, ever suggests endangering health to accomodate people’s over-squeamishness. In fact, she has commented quite negatively on such squeamishness. Ann Landers, on the other hand… ---
**Author:** ![Troy\_McClure\_SF](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/troy_mcclure_sf/32/4150_2.png) [@Troy\_McClure\_SF](https://boards.straightdope.com/u/Troy_McClure_SF)\ **Post date:** [May 12, 2005, 10:05pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/279 "2005-05-12T22:05:10Z")
**Oy!** , not so much on this issue, but the idea that one random putz is arbitrarily supposed to be this font of wisdom about shit that no one should ever spend more than a second thinking about anyway just bugs the shit out of me. ---
**Author:** ![beckwall](https://avatars.discourse-cdn.com/v4/letter/b/b487fb/32.png) [@beckwall](https://boards.straightdope.com/u/beckwall)\ **Post date:** [May 12, 2005, 10:16pm UTC](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240/280 "2005-05-12T22:16:53Z")
**Cagey Drifter** , thanks for the link. That’s what I’m talking about, just showing some compassion to your fellow humans. [Previous page](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240.md?page=13) [Next page](https://boards.straightdope.com/t/people-with-diabetes-shouldn-t-inject-insulin-publicly/303240.md?page=15)