Diabetes in Children: Giving Insulin Shots to a Child

How is insulin prepared and given?

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. Insulin stored at room temperature will last for about a month. Read and follow all instructions on the label, including how to store the insulin and how long the insulin will last.
   • 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.

• To prepare an injection with a single type of insulin, follow the steps for preparing a single dose of insulin.
• To prepare an injection containing two types of insulin, follow the steps for preparing a mixed dose of insulin.

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).