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We studied whether the use of 8 mm insulin pen needles, shorter than the standard 12.7 mm needles, affects glucose control in obese and non-obese people with type 1 or type 2 diabetes. A prospective, open-label, nine-week, crossover study involved 106 insulin pen-using patients. During the initial period, all subjects used B-D brand standard length needles. In the second period, subjects were randomised to either B-D or NovoFine brand 8 mm pen needles. In the third period, subjects were crossed over to the alternative brand. Fructosamine levels were measured, leakage of insulin from injection sites was quantified, and pain was assessed. Glucose control was not altered in either obese or nonobese subgroups after switching to either brand of 8 mm needle. However, a few individuals, most of whom were obese, experienced a clinically significant increase in fructosamine levels after switching to an 8 mm needle. B-D 8 mm needles were significantly less painful than either of the other needles tested. Obese subjects were significantly more likely to experience insulin leakage from their injection sites compared to non-obese people, but the leakage was not significantly correlated with changes in fructosamine levels. Non-obese people with type 1 or type 2 diabetes can switch to 8 mm insulin pen needles without compromising their glucose control and with less pain. Some obese patients who switch to 8 mm needles may have a higher risk of poorer glucose control, and should therefore consult with their healthcare professional. All patients should carefully monitor their blood glucose when changing to a shorter needle. [ABSTRACT FROM AUTHOR]