Federal officials said they have become increasingly concerned about the risks of transmitting blood-borne viruses when diabetics are assisted with testing their blood sugar levels and insulin injections, and equipment is unsafely reused with multiple patient. Outbreaks of hepatitis B associated with blood sugar monitoring have been identified with increasing regularity, particularly in long-term care settings such as nursing homes and assisted living facilities, where residents often require assistance with testing and insulin injections, according to the U.S. Centers for Disease Control and Prevention. In the past 10 years, at least 15 hepatitis B outbreaks have been associated with providers failing to follow basic principles of infection control when assisting with blood glucose monitoring. Because of underreporting and under-recognition of infection, the number of outbreaks likely has been underestimated, the CDC says. Safe use of diabetes management equipment is a major concern as more Americans are diagnosed with the disease and as aging boomers move into assisted living facilities, said Joe Perz, an epidemiologist in the CDC's Division of Healthcare Quality Promotion. "This is what we call infection control 101," he said. "One of the most common myths is that contamination is limited to the needle. An insulin cartridge is a form of syringe. And a syringe and needle should be seen as a single device. One can contaminate the other."