Actionsets help people take an active role in managing a health condition.  Giving an insulin injection to a child with diabetes

How? - Learn the steps involved in taking action. 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.

  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. You will need an insulin syringeClick here to see an illustration., 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.
  3. 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.

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 areasClick here to see an illustration. 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.

  1. Slightly pinch a fold of skin between your fingers and thumb of one hand.
  2. 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.
  3. Bend your wrist and quickly push the needle all the way into the pinched-up area. Then let go of the pinched-up area.
  4. Gently pull back the plunger a small amount to make sure that you have not put the needle into a blood vessel. If you see blood, pull out the needle and inject it in another spot. If you do not see blood, go to the next step.
  5. 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.
  6. 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.
  7. 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 slide show on giving an insulin injection into the stomach using an insulin penClick here to see an illustration. to see photographs of a child using an insulin pen to give an injection in the stomach.

View the slide show on giving an insulin injection into the armClick here to see an illustration. 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 slide show of steps for preparing a single dose of insulinClick here to see an illustration.. 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 slide show of steps for preparing a mixed dose of insulinClick here to see an illustration..

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 slide shows of steps for preparing a single dose of insulinClick here to see an illustration. and steps for preparing a mixed dose of insulinClick here to see an illustration. before answering these questions.

  1. The first step in preparing insulin from a bottle is to roll the bottle gently between your hands.

    1. True
    2. False
  2. When you are preparing a cloudy and a clear insulin to give a mixed dose, which do you put into the syringe first?

    1. Cloudy insulin
    2. Clear insulin

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Author: Monica RhodesLast Updated: February 22, 2007
Medical Review: Caroline S. Rhoads, MD - Internal Medicine
Matthew I. Kim, MD - Endocrinology & Metabolism
Andrew Swan, MD, CCFP, FCFP - Family Medicine

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