Overview

Insulin is normally made by the pancreas, a gland behind the stomach. In children with type 1 diabetes, the pancreas no longer makes enough insulin or it stops making it. Without insulin, your child's blood sugar level rises to dangerous levels. When this happens, your child needs insulin shots to keep blood sugar at a safe level.

You may be nervous giving your child a shot at first. But soon, giving the shot will become routine. It is quite easy to learn how to draw up insulin into a syringe and give the shot. The needles you use to give the insulin injections are very thin, and most children who have diabetes say that they do not even feel the needle enter the skin. Even if your child does feel the injection, the sting of the shot is not bad and does not last long. Many parents give their children shots. You can too.

How can you care for your child at home?

Getting started

• Gather your supplies. You will need an insulin syringe, your bottles of insulin, and an alcohol wipe or a cotton ball dipped in alcohol. Keep your supplies in a bag or kit so you can carry the supplies wherever you and your child go.
• Check the labels on the bottles and contents. Read and follow all instructions on the label, including how to store the insulin and how long the insulin will last.
• Wash your hands with soap and running water. Dry them well.

Preparing the shot

To prepare a single-dose insulin shot:

1. Roll the bottle gently between your hands. This will warm the insulin if you have kept the bottle in the refrigerator. Roll a bottle of cloudy insulin between your hands until the white powder has dissolved.
2. Wipe the rubber lid of the insulin bottle with an alcohol wipe or a cotton ball dipped in alcohol. (If you are using a bottle for the first time, remove the protective cover over the rubber lid.) Let the top dry before you remove any insulin.
3. Remove the plastic cap from the needle on your insulin syringe. Take care not to touch the needle.
4. Pull the plunger of the syringe back, and draw air into the syringe equal to the number of units of insulin to be given.
5. Insert the needle of the syringe into the rubber lid of the insulin bottle. Push the plunger of the syringe to force the air into the bottle. This equalizes the pressure in the bottle when you remove the dose of insulin. Leave the needle in the bottle.
6. Turn the bottle and syringe upside down, and hold them in one hand. Position the tip of the needle so that it is below the surface of insulin in the bottle. Pull back the plunger to fill the syringe with slightly more than the correct number of units of insulin to be given.
7. Tap the outside (barrel) of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle. Make sure you now have the correct number of units of insulin in your syringe.
8. Remove the needle from the bottle. Now you are ready to give your child the shot.

Giving your child the shot

1. Make sure the area of skin where you will give the shot is clean. If you use alcohol to clean the skin before you give the injection, let it dry.
2. Slightly pinch a fold of skin between your fingers and thumb of one hand.
3. Hold the syringe like a pencil close to the site, keeping your fingers off the plunger. It is usually recommended to place the syringe at a 90-degree angle to the shot site, standing straight up from the skin.
4. Bend your wrist, and quickly push the needle all the way into the pinched-up area.
5. Push the plunger of the syringe all the way in so the insulin goes into the fatty tissue.
6. Take the needle out at the same angle that you inserted it. If your child bleeds a little, apply pressure over the shot area with your finger, a cotton ball, or a piece of gauze. Do not rub the area. Check your child's blood sugar more often on the days when bleeding occurs.
7. Replace the cover over the needle and dispose of the needle safely. Do not use the same needle more than one time.

Where to give the shot

You can inject insulin at a few places on the body. The places include:

• The belly, but at least 5 centimetres (2 inches) from the belly button. This is considered the best place to inject insulin.
• The top outer part of the thighs. Insulin usually is absorbed more slowly from this site, unless your child exercises soon after getting the shot.
• The outside of the upper arms or the buttocks.

Your doctor may advise you to give the shots in different places on your child's body each day. This is called site rotation. Make sure you talk to the doctor about how to do this safely. If you rotate sites, use the same site at the same time of each day. For example, each day:

• At breakfast, give the shot in one of your child's arms.
• At lunch, give the shot in one of your child's legs.
• At dinner, give the shot in your child's belly.

Slightly change the spot where you give an insulin shot each time you do it. For example, use five different places on the right upper arm, then use five places on the left upper arm. Using the same spot every time can cause bumps or pits in the skin and make the shots hurt more. It may also slow down how the insulin is absorbed into your child's body.