Giving an insulin injection to a child with diabetes

How is insulin prepared and given?
Your health professional 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 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.
To prepare an injection with a single type of insulin, follow the instructions in the slideshow of steps for preparing a single dose of insulin .
To prepare an injection containing two types of insulin, follow the instructions in the slideshow of steps for preparing a mixed dose 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 stomach 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 stomach, 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 so the injection will be less painful.
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. Check your child's blood sugar more frequently on the days when bleeding occurs. This is because blood means you have hit a blood vessel. When the insulin goes right into the blood stream, instead of just into the skin, it works more quickly and can lead to low blood sugar.
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 stomach using an insulin pen to see photographs of a child using an insulin pen to give an injection in the stomach.
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 health professional 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. See precautions when mixing insulin for more information.
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 steps for preparing a single dose of insulin . Give a copy of the steps to a health professional 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 steps for preparing a mixed dose of insulin .
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 health professional 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 health professional 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 steps for preparing a single dose of insulin and steps for preparing a mixed dose of insulin before answering these questions.
The first step in preparing insulin from a bottle is to roll the bottle gently between your hands.
True
False
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
Clear insulin
Continue to Where to go from here
Return to Giving an insulin injection to a child with diabetes


Author:	Monica Rhodes	Last Updated: January 30, 2007
Medical Review:	Ruth Schneider, MPH, RD - Diet and Nutrition Rhonda O'Brien, MS, RD, CDE - Diabetes Educator
© 1995-2008 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.