Diabetes in Children: Giving Insulin Shots to a Child
What is an Actionset?
Insulin is available only in an injectable form that is given into the fatty tissue just under the skin. Most people use insulin in an injection, or shot. While it can also be given through an insulin pump or jet injector, this information does not pertain to these devices. Get information from your child's doctor about how to use these properly.
You will need to give your child's insulin injections until he or she is able to give his or her own injections. After you get over the initial anxiety, insulin injections will become a routine part of your day. It's easy to learn the basics of preparing the insulin (drawing it up into a syringe) and then injecting it. The new thinner, shorter needles on insulin syringes make injections much less uncomfortable than they used to be.
The three most important elements of success in giving insulin injections include:
- Making sure you have the right dose of insulin, especially if you are giving two types of insulin in the same syringe.
- Practicing how to give an injection.
- Storing insulin properly so that each dose will work effectively.
More information about children with diabetes can be found in these topics:
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Insulin is a hormone produced in the pancreas. It lets sugar (glucose) enter body cells, where it is used for energy. It also helps the body store extra sugar in muscle and liver cells. The stored sugar can be released later and used for energy when needed.
Insulin for injection comes in small glass bottles, or vials, and in cartridges. Both are sealed with a rubber lid. One vial or cartridge contains many doses. To remove a dose of insulin from:
- A vial: Use an insulin syringe. The syringe is also used to inject the insulin.
- A cartridge: Use a pen-shaped device called an insulin pen. The cartridge fits inside the pen and the dose of insulin is set with a dial on the outside of the pen. The pen is used to give the insulin.
Some insulin pens work with premixed insulin cartridges, such as Humulin 70/30, NovoLog Mix 70/30, and Humalog Mix 50/50.
To give an insulin injection, the needle is inserted through the skin. The medicine is pushed from the syringe into fatty tissue just below the skin. Insulin usually is injected into the abdomen, upper arm, buttocks, or thigh.
Your child may need to take two types of insulin at the same time. Because most types of insulin that are prescribed to be taken at the same time can be mixed together, you can give both doses in the same syringe.
If your child has type 1 diabetes, his or her body no longer produces insulin. Because insulin is not available, sugar cannot enter body cells to be used for energy. As a result, the blood sugar level rises. Insulin injections are needed to keep blood sugar levels within a target range when a person has type 1 diabetes.
If your child has type 2 diabetes, either the pancreas isn't able to produce enough insulin or your child's body tissues have become resistant to insulin. Children with type 2 diabetes may need to take medicine to control their blood sugar.
Your child with type 2 diabetes may need insulin if eating a balanced diet, getting regular exercise, and taking other medicine have not kept his or her blood sugar levels within a target range. Your child may now need insulin injections either alone or in combination with other medicine.
Your doctor or certified diabetes educator (CDE) will help you and your child learn to prepare and give insulin injections. If your child is age 10 or older, he or she may be able to give insulin with supervision. Here are some simple steps to help you and your child learn this task.
To get ready to give an insulin injection using an insulin vial and insulin syringe, follow these steps.
- Wash your hands with soap and running water. Dry them thoroughly. If your child is going to help, wash his or her hands well.
- Gather the supplies. You will need an insulin syringe, the vial(s) of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Keep the supplies in a bag or kit so your child can carry the supplies wherever he or she goes.
- Check the insulin bottle label and contents. When an insulin vial is used for the first time, write the date on the bottle. On the 30th day after opening, throw the bottle with any remaining insulin away. Insulin may not work as well after 30 days of use.
Prepare the injection
The preparation will depend on whether you are giving one type of insulin or mixing two types of insulin in the injection.
When you are mixing types of insulin to be given in one syringe, follow these precautions.
- If you are mixing NPH and short-acting regular insulin, you can use it right away or put it aside to be used later. Keep it away from heat and light, such as in a refrigerator.
- Insulin glargine (Lantus) and insulin detemir (Levemir) cannot be mixed with other types of insulin. They also cannot be given in a syringe that has been used to give another type of insulin.
Prepare the site
Before giving the injection, take the time you need to do the following:
- Choose the place (injection site). See the diagram of injection areas for where to give insulin injections. The belly is the most common area. If you give the injections in different places on your child's body each day (rotate sites), use the same site at the same time of the day. If your child will be physically active soon after the injection, use a site that will have the least movement in the activity. The absorption of insulin is faster in an area that gets movement, which could lead to low blood sugar. For example, if you give your child an insulin shot right before he or she plays soccer, give the shot in the belly, rather than in the leg.
- An example of rotating sites:
- At breakfast, give the insulin into one of your child's arms.
- At lunch, give the insulin into one of your child's legs.
- At dinner, give the insulin into your child's abdomen.
- Clean the site. If you use alcohol to clean the skin before you give the injection, let it dry.
- Have your child relax the muscles in the area of the injection.
Give the injection
Follow these steps for giving an insulin injection.
- Slightly pinch a fold of skin between your fingers and thumb of one hand. But if you are using a shorter insulin needle, pinching the skin is not needed. Shorter needles make it easier to inject insulin into areas with less fat, such as the upper arm.
- Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. Usually the syringe is at a 90-degree angle to the skin site. If you are giving the injection to a small child with little fat, you may want to insert the needle at a 45-degree angle or use a shorter needle.
- Bend your wrist and quickly push the needle all the way into the pinched-up area. Then let go of the pinched-up area.
- Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue. Count to 5 before taking the needle out, so that some of the insulin doesn't "leak" out.
- Take the needle out slowly at the same angle that you inserted it. If your child bleeds a little, apply pressure over the injection site with your finger, a cotton ball, or piece of gauze. Do not rub the area.
- Replace the cover over the needle. Although syringe manufacturers do not recommend it, some people reuse their syringes until the needle becomes dull or bent. If you plan to reuse your syringe, see precautions when reusing syringes.
View the slideshow on giving an insulin injection into the belly using an insulin pen to see photographs of a child using an insulin pen to give an injection in the belly.
View the slideshow on giving an insulin injection into the arm to see photographs of a child giving an insulin injection in the arm using a syringe.
Cleanup and storage
After giving your child's injection, be sure to:
- Store the insulin properly so that each dose from the bottle will work effectively.
- Dispose of the used syringe and lancet. Do not throw a used syringe, needle, or lancet in a trash can. You can dispose of them in a metal container with a lid that screws on or that you tape down tightly. You also can buy special containers for disposing of used needles and syringes. You can buy a small needle clipper device that breaks the needle off the syringe and stores it safely for disposal. Talk with your local trash disposal agency or your doctor about how to get rid of the container.
Other tips for success and safety
Some tips to help you be safe and successful in giving your child insulin injections include the following:
- You and your child can practice injecting air or water into an orange until you feel comfortable with the steps for giving insulin. Then do the steps in front of a doctor or certified diabetes educator and ask him or her how you did. Practice more if you or your child needs to. If you think that you can do the task well, give your child a dose of insulin while a doctor watches. Let your child do this if he or she is ready to try.
- Teach other family members how to give insulin injections. Have at least one other person who can prepare and give your child's insulin injection in an emergency. It's a good idea to let this person give your child an injection now and then for practice. Then it will not be as unfamiliar when an emergency occurs.
- Never share syringes with another person because of the risk of getting diseases that can be transferred through blood, such as acquired immunodeficiency syndrome (AIDS) or infection of the liver (hepatitis).
Now that you have read this information, you are ready to start preparing and giving insulin injections to your child.
If you would like more information on preparing and giving insulin injections, the following resources are available:
|American Diabetes Association (ADA)|
|1701 North Beauregard Street|
|Alexandria, VA 22311|
|Phone: ||1-800-DIABETES (1-800-342-2383)|
|Web Address: ||www.diabetes.org|
The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.
|Primary Medical Reviewer||John Pope, MD - Pediatrics|
|Specialist Medical Reviewer||Stephen LaFranchi, MD - Pediatrics, Pediatric Endocrinology|
|Last Revised||December 4, 2012|
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