What insulin pen needle size and gauge should be ordered for the Tresiba (insulin degludec) FlexTouch pen?

Needle Specifications for Tresiba FlexTouch Pen

Order 4 mm, 32-gauge pen needles for the Tresiba FlexTouch pen 1.

Recommended Needle Specifications

Length

• 4 mm pen needles are recommended for all adults and children using Tresiba FlexTouch 1
• This length is sufficient to traverse the skin and reliably deliver insulin to the subcutaneous tissue while avoiding intramuscular injection
• If 4 mm needles are unavailable, 5 mm needles are an acceptable backup 1

Gauge (Width)

• 32-gauge is recommended for most adults with diabetes 1
• Higher gauge numbers indicate thinner needles, which reduce injection pain
• The needle wall should be thin to create a larger lumen enabling higher flow rate 1

Additional Needle Features to Consider

• 5-bevel tip geometry is preferred over 3-bevel to minimize skin penetration force 1
• Contoured base design distributes pressure more widely across the skin surface compared to posted bases, reducing overall injection force 1
• Needle lubrication should be present to reduce penetration force 1

FDA-Approved Compatible Needles

According to the Tresiba FDA label, the FlexTouch pen is recommended for use with NovoFine®, NovoFine® Plus, or NovoTwist® disposable needles 2.

Injection Technique Considerations

• Inject at 90° angle for most adults using 4-5 mm pen needles 1
• No skin lift is needed for most patients when using 4 mm needles at 90° 1
• Skin lift IS required for specific populations using 4 mm needles:
  • Low BMI (<19 kg/m²) or lean body mass patients 1
  • Children ≤6 years old 1
  • Older adults with very thin skin (individualized assessment) 1

Critical Safety Points

• Never reuse needles - this prevents infection, maintains needle sharpness and lubrication, and ensures optimal injection experience 1
• Never share FlexTouch pens between patients, even if the needle is changed, due to risk of blood-borne pathogen transmission 2
• Inject insulin at room temperature rather than cold to reduce discomfort 1

Common Pitfalls to Avoid

• Do not order 6 mm or 8 mm needles - these increase risk of painful intramuscular injection 1
• Do not use syringes to withdraw insulin from the FlexTouch pen 2
• Avoid needles with posted bases if patients have dexterity challenges like arthritis, as these concentrate pressure at the injection site 1