Diabetes in Children: Giving Insulin Shots to a Child

Introduction

Insulin is available only in an injectable form that is given into the fatty tissue just under the skin.

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 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:

  • A vial: Use an insulin syringe 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. Insulin pens are either disposable or reusable. Disposable pens include a prefilled cartridge. Reusable pens can be refilled with new cartridges of insulin again and again.

To give an insulin injection, the needle of the syringe or pen is inserted through the skin. The medicine is pushed 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 may be able to give both doses in the same syringe. Some insulin pens work with premixed insulin cartridges, such as Humalog Mix 50/50, Humulin 70/30, and NovoLog Mix 70/30.

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 or pen 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 or pen 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 or pen is inserted into the skin, and the medicine is pushed into the fatty tissue just under the skin.

  •  

Continue to Why?

 

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.

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.

  •  

Continue to How?

 

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.

Get ready

To get ready to give an insulin injection using an insulin vial and insulin syringe or an insulin pen, follow these steps.

  1. Wash your hands with soap and running water. Dry them thoroughly. If your child is going to help, wash his or her hands well.
  2. Gather the supplies. Keep the supplies in a bag or kit so your child can carry the supplies wherever he or she goes.
    • You will need an insulin syringe and the vial(s) of insulin, and an alcohol wipe or a cotton ball dipped in alcohol.
    • If you are using an insulin pen, you will need a needle that works with your pen. If the pen is reusable, you may need an insulin cartridge. You may also need an alcohol swab.
  3. Check the insulin bottle or cartridge.
    • 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.
    • On a reusable insulin pen, note the date you started using the pen. Reusable pens expire (for example, after several years).
    • Check that a disposable pen's insulin has not expired. This date is usually printed on the pen's label.

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.

If you are using an insulin pen, follow the manufacturer's instructions for attaching the needle, priming the pen, and setting the dose.

Prepare the site

Before giving the injection, take the time you need to do the following:

  • Choose where you want to give the injections (injection site). 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 belly.
  • 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 the steps for giving an insulin injection in the belly. It's also possible for a child to give the shot to himself or herself in the arm.

Follow the steps for giving an insulin injection into the belly with a reusable insulin pen.

Cleanup and storage

After giving your child's injection, be sure to:

  • Store the insulin properly so that each dose will work effectively. Follow the instructions that come with the insulin.
  • Dispose of the used syringe, disposable insulin pen, or needle. Do not throw a used syringe, needle, or insulin pen 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, pharmacy, 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).

Test Your Knowledge

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.

  •  

Continue to Where?

 

Now that you have read this information, you are ready to start preparing and giving insulin injections to your child.

To learn more about 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.


To learn more about children with diabetes see:

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Credits

By Healthwise Staff
Primary Medical Reviewer John Pope, MD - Pediatrics
Specialist Medical Reviewer Stephen LaFranchi, MD - Pediatrics, Pediatric Endocrinology
Last Revised August 13, 2013

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