FIT Insulin Injection Day was observed in Mumbai and other parts of the country, with the adoption of FIT2.0 India recommendations. Amongst other best practices, the recommendations emphasize safe disposal of insulin syringes and pen needles as a means to reduce environmental impact of modern diabetes management.

On this occasion, the advisory board members of Forum for Injection Technique (FIT) India propagated the message of 'Go Green Stay Fit' in line with the article on Green Diabetology published in Indian Journal of Endocrinology and Metabolism,IJEM (Indian J Endocrinol Metab. 2015 Nov-Dec; 19(6): 698–700 emphasizing the urgent need for proper disposal of insulin delivery sharp devices.

As per the article, over 200 million insulin delivery devices are generated in India each year. Approximately 65 million Indians living with diabetes consume about 160 million insulin syringes and about 50 million pen needles annually, along with about 40 million syringes used for immunization. Most of these devices are disposed of under unsafe circumstances.

Apart from this, roughly 9.6 crore (96,000,000) vials, cartridges and prefills are consumed in a 12-month period (6.7 crore vials, 2.5 cartridge and 0.7 disposable pens), adding to the burden of glass and plastic on the environment.

The net amount of plastic generated from insulin syringes alone, each year is 600,000 kg. This excludes the plastic generated from more than 40 million pen needles used every year in India.

It is worrisome that most of these devices are not disposed off safely subjecting the care-taker and the community to health risks

“While modern insulin technique guidelines address the need for appropriate disposal of needles and syringes, safe disposal of insulin delivery sharps is seldom practiced in clinic and home care environment,”said Dr Sanjay Kalra, FIT advisory broad member and lead author of the IJEM ‘Green Diabetology’ article.

Apart from environmental contamination, unsafe disposal is having an adverse impact on healthcare worker safety. As per CDC, every day more than 1000 healthcare workers in hospital setting are injured with a needle or other sharp device. This especially happens during insulin syringe / pen needle re-capping, intended for re-use. The WHO in the Policy Guidance released in February 2015, has identified the issue of re-use of syringes, accidental needle stick injury, unsafe sharps waste management.

As per the FIT recommendations, biomedical diabetes care –related wastes need to recycled, not reused. This can not only prevent the spread of infections among waste handlers and end-users but also promote conservation and efficiency, and help in revenue generation for waste disposal sites.In an effort to address safe and environment-friendly insulin disposal, healthcare professionals will initiate a nation-wide movement for green diabetology Go Green Stay Fit, which shall aim towards safe disposal of insulin

The programme will also sensitize diabetes care professionals to their responsibility toward the physical environment, while reinforcing the need for interdisciplinary cooperation between all stakeholders.

“Under the Green Diabetology programme, we will be propagating safe disposal of insulin syringes and pen needles, prevention of reuse and education against re-capping insulin injecting devices to prevent accidental needle-stick injury. We will encourage adoption of simple practices that will facilitate optimal recycling and usage of insulin-related waste material while providing a source for revenue generation as well,” said Dr Hemraj B. Chandalia, director, department of endocrinology, diabetes and metabolism, Jaslok Hospital & Research Centre, Mumbai.

FIT India is an autonomous organisation which supports people with diabetes using injectable therapies to achieve the best possible health outcomes that can be influenced by correct injection technique. The development of FIT and the subsequent India recommendations for injection technique have been supported by prominent medical technology firm Becton, Dickinson & Co. (BD India).