Diabetes in Children: Giving Insulin Shots to a Child
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
Reference insulin pump Opens New Window 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.
Insulin is a
hormone produced in the
Reference pancreas Opens New Window. 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
Reference insulin syringe Opens New Window Reference
Opens New Window. 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.
Both disposable and reusable insulin pens are available. Each pen operates
slightly differently.
Note: If your child is using
a disposable insulin pen, talk with your child's doctor or pharmacist about how to use
the pen properly. Giving insulin with these pens is not covered in this
information.
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.
Test Your Knowledge
-
Insulin is a hormone made by the
pancreas.
-
True
This answer is correct.
Insulin is a hormone made by the pancreas.
Insulin 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.
-
False
This answer is incorrect.
Insulin is a hormone
made by the pancreas. Insulin 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.
-
To withdraw a single dose of insulin from a vial, I
need to use a syringe.
-
True
This answer is correct.
To withdraw a single dose of insulin from a
vial, you do need to use a syringe.
-
False
This answer is incorrect.
To withdraw a single dose of insulin from a
vial, you do need to use a syringe.
-
To give an injection of insulin, the needle of the
syringe is inserted into the skin and the medicine is pushed into the fatty
tissue just under the skin.
-
True
This answer is correct.
To give an injection of insulin, the needle of
the syringe is inserted into the skin and the medicine is pushed into the fatty
tissue just under the skin.
-
False
This answer is incorrect.
To give an injection of insulin, the needle of
the syringe is inserted into the skin, and the medicine is pushed into the
fatty tissue just under the skin.
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 necessary to keep
blood sugar levels within a target range when a person has type 1
diabetes.
If your child has
Reference type 2 diabetes Opens New Window, either the pancreas isn't able to
produce enough insulin or your child's body tissues have become
Reference resistant to insulin Opens New Window. Children with type 2 diabetes
may need to take oral diabetes pills to control their blood sugar.
Your child with type 2 diabetes may need insulin if eating a balanced
diet, getting regular exercise, and taking diabetes pills 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 oral medicine.
Test Your Knowledge
-
In type 2 diabetes, the pancreas does not produce
enough insulin or the body tissues are resistant to insulin.
-
True
This answer is correct.
In type 2 diabetes, the pancreas does not
produce enough insulin or the body tissues are resistant to insulin. Because
insulin is not available, sugar cannot enter body cells to be used for energy.
As a result, blood sugar level rises.
-
False
This answer is incorrect.
In type 2 diabetes, the pancreas does not
produce enough insulin or the body tissues are resistant to insulin. Because
insulin is not available, sugar cannot enter body cells to be used for energy.
As a result, blood sugar level rises.
Your doctor 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.
Get ready
To get ready to give an insulin
injection, 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
Reference insulin syringe Opens New Window Reference Opens New Window, 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
Reference 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 refrigerate it to be used
later.
- 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.
- Lente insulin should not be mixed with regular insulin.
- Do not mix human- and animal-source insulins in the same syringe.
Prepare the site
Before giving the injection, take
the time you need to do the following:
- Choose the place (injection site). See the
Reference diagram of injection areas Opens New Window Reference Opens New Window 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.
- 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.
- 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
Reference precautions when reusing syringes.
View the slideshow on
Reference giving an insulin injection into the belly using an insulin pen Opens New Window Reference 
Opens New Window to see
photographs of a child using an insulin pen to give an injection in the
belly.
View the slideshow on
Reference giving an insulin injection into the arm Opens New Window Reference Opens New Window 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:
-
Reference 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:
- 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 periodically for practice. Then it will not be as
unfamiliar when an emergency occurs.
- Do not mix other medicine with
insulin without your doctor's instruction. Some types of insulin cannot be
mixed together.
- 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).
Test Your Knowledge
Practice
Review the slideshow of
Reference steps for preparing a single dose of insulin Opens New Window Reference Opens New Window. Give a copy of the steps to a doctor
or someone else and have the person watch you prepare your child's dose of
insulin. Ask the person to tell you how well you did. Repeat this process as
many times as you need to. Allow your child to participate in the task, and
help him or her learn the skill as well.
Use the same process for
preparing a mixed dose of insulin, if your child needs to take two types of
insulin in one shot. Review the slideshow of
Reference steps for preparing a mixed dose of insulin Opens New Window Reference Opens New Window.
You and your child can
practice giving 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 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.
Answer these questions
Answer the following questions to see whether you understand how to
prepare and give an insulin injection. Review the slideshows of
Reference steps for preparing a single dose of insulin Opens New Window Reference Opens New Window and
Reference steps for preparing a mixed dose of insulin Opens New Window Reference Opens New Window before answering these
questions.
-
The first step in preparing insulin from a bottle is
to roll the bottle gently between your hands.
-
True
This answer is correct.
The first step in preparing insulin from a
bottle is to roll the bottle gently between your hands. This will warm the
insulin if you have been keeping the bottle in the refrigerator. Roll a bottle
of cloudy insulin until the white powder has dissolved.
-
False
This answer is incorrect.
The first step in preparing insulin from a
bottle is to roll the bottle gently between your hands. This will warm the
insulin if you have been keeping the bottle in the refrigerator. Roll a bottle
of cloudy insulin until the white powder has dissolved.
-
When you are preparing a cloudy and a clear insulin to
give a mixed dose, which do you put into the syringe first?
-
Cloudy insulin
This answer is incorrect.
When you are preparing a cloudy and a clear
insulin to give a mixed dose, you put the clear insulin
into the syringe first.
-
Clear insulin
This answer is correct.
When you are preparing a cloudy and a clear
insulin to give a mixed dose, you put the clear insulin into the syringe first.
Now that you have read this
information, you are ready to start preparing and giving insulin injections to
your child.
Talk with your child's doctor
If you have questions about this information, take
it when you visit the doctor. You may want to mark areas or make notes in the
margins on the pages where you have questions.
If you would like more information on preparing and giving
insulin injections, the following resources are available:
Organization
| American Diabetes Association (ADA) |
| 1701 North Beauregard Street |
| Alexandria, VA 22311 |
| Phone: | 1-800-DIABETES (1-800-342-2383) |
| Email: | AskADA@diabetes.org |
| 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.
|
|
More information about children with diabetes can be
found in these topics:
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