For Kids: Taking Your Insulin
The digestive system breaks down food,
resulting in a sugar called glucose. Some of this glucose is stored in the liver.
But most
of it enters the bloodstream and travels to the cells to be used as fuel. Glucose
needs the
help of the hormone insulin to enter the cells. Insulin is made in the pancreas, an
organ
in the abdomen (belly). The insulin is released into the bloodstream in response to
the
presence of glucose in the blood.
Think of insulin as a key. When
insulin reaches a cell, it attaches to the cell wall. This signals the cell to create
an
opening that allows glucose to enter the cell. Without insulin, your cells can’t get
glucose to burn for energy. This is why you may feel weak or tired.
The insulin you are missing can be
replaced with shots of insulin (injections). Some children also use insulin pumps.
Then
your body can burn glucose for energy. This helps keep your blood sugar within a healthy
range.
Feeling nervous is normal
Most people with diabetes are
scared to give themselves insulin injections at first. Even your parents were probably
nervous giving you your first injections. But after a while, it became much easier.
With
a little practice, you’ll get used to injections, too. And pretty soon you won’t feel
nervous or scared.
Types of insulin
The types of insulin are:
-
Fast-acting insulin. Take fast-acting insulin with meals. You have to eat
within 15 minutes of taking it.
-
Regular or short-acting insulin. Short-acting insulin is also usually
taken before a meal. It will usually reach the bloodstream within 30 minutes after
injection.
-
Intermediate-acting insulin. Intermediate-acting insulin takes longer to
start working than fast-acting insulin. But it stays in your bloodstream
longer.
-
Long-acting insulin. Long-acting insulin makes sure there is a little
insulin in your bloodstream at all times. It helps keep your blood sugar in
control. These shots can last the whole day.
Using a syringe
Always test your blood sugar before
injecting insulin. Blood sugar readings help you decide how much insulin to give
yourself. When injecting insulin, make sure you inject into the fat just under the
skin.
Many people with diabetes inject using a syringe.
Ask your healthcare provider to teach you how to rotate your
injection site. Also ask how to prevent injecting into areas of lipohypertrophy. This
is
a bump under the skin caused by injecting insulin in the same spot many times. Also
ask
about how to inject insulin correctly and how to prevent injecting insulin into the
muscle. This is to make sure insulin is absorbed in the correct way.
Follow the steps below for
injecting insulin with a syringe.
Step 1: Getting ready
-
Gather your
supplies. Here’s what you’ll need:
-
A new syringe
-
Insulin
-
Alcohol wipes
-
Special container to
throw out the old needle (sharps container). This can be bought at a
drugstore or medical supply store. Or you can use any puncture-proof
container with a puncture-proof lid, like an empty laundry detergent
bottle.
-
Parent, teacher, or
another adult to watch
-
Wash your hands. Use soap
and warm water.
-
Clean the insulin
bottle. Wipe the top of the rubber top (stopper) of the insulin bottle (vial)
with an alcohol wipe.
-
Prepare the insulin. If
you use cloudy insulin, roll the bottle gently between your hands about 20
times. Don’t shake the insulin. And don’t use cold insulin. Instead, keep 1
bottle at room temperature and put the rest in the refrigerator.
Step 2: Preparing the
syringe
-
Remove the syringe from
its package.
-
Take the cap off the
needle.
-
Draw air into the
syringe. Pull back the plunger to get air into the syringe. Pull the plunger
back to the mark (line) for the number of units of insulin you want to
inject. The mark on the syringe nearest the needle is 0 (not 1).
-
Inject air into the
insulin. Hold the bottle on a flat surface with one hand. With your other hand,
hold the syringe straight up and down. Slowly push in the plunger to inject air
into the insulin.
-
Turn bottle with the
syringe upside down. Keep the needle in the stopper. Flip the syringe and
bottle so that the bottle is now on top, and the syringe is on the bottom. Be
careful not to bend the needle when tipping the insulin bottle.
-
Draw insulin into the
syringe. Keep the tip of the needle below the level of insulin. You may need to
pull the needle out a little. Slowly pull back the plunger to draw out insulin.
Ask an adult to check the dose.
-
Check for air
bubbles. Gently tap the syringe while the needle is still in the stopper. The
air bubbles will move to the top of the syringe. Push the plunger in a tiny bit
to release the air bubbles back into the insulin bottle. Your healthcare
provider, nurse, or a diabetes educator may show you other ways to remove air
bubbles.
-
Remove the needle from the
insulin bottle.
Step 3: Giving the
injection
-
Clean the injection
site. Use an alcohol wipe to clean the area where you’re going to inject. Let
the area air-dry. If the skin is wet with alcohol, the injection will
sting.
-
Pinch an inch of skin.
Pull up about 1 inch of skin. Pinch the skin gently. Don’t squeeze it. This is
to make sure you don’t inject into a muscle.
-
Insert the needle. Insert
the needle into the skin at the angle you were shown. Push the needle in until
you can’t see it anymore.
-
Inject the insulin. Slowly
push in the plunger until the syringe is empty.
Step 4: Removing the needle
-
Count to 5 before pulling
out the needle.
-
Remove the needle from the
skin.
-
Watch the injection site
for leaking insulin and for bleeding. If the site bleeds, dab it with a cotton
ball or tissue. If insulin leaks, ask your healthcare provider, nurse, or
diabetes educator to make sure you are doing it correctly.
Step 5: After the injection
Using an insulin pen
You can also use injection pens to
get the insulin you need. Injection pens look like writing pens. Insulin pens hold
cartridges of insulin. A new needle is used for every injection. There are different
kinds of insulin pens. Your healthcare provider, nurse, or diabetes educator will
tell
you which pen is best for you. One of them will also show you how to use the pen. Smart
pens are also called connected insulin pens. These pens can be programmed to calculate
insulin doses. They send the information to your smartphone.
Tips for pen users
-
Wash your hands with soap and
water.
-
Clean the injection site with
an alcohol wipe.
-
Use a new needle each
time.
-
Never leave the needle on the
pen when you’re not using it.
-
Before injecting, tap the
needle with your fingertip to get rid of air bubbles.
-
Then test the pen by dialing
to 2, pressing the injection button all the way. Insulin should come out of the
needle when you do this. If not, check for air bubbles again. Then test again. If
no insulin comes out after 3 tries, start over with a new needle. It may also be
time to change the cartridge with insulin.
-
Ask an adult to check the
insulin dose you have dialed for yourself.
- There are different types of pen needles. Know what type you are
using and how to use it.
-
Standard pen needle. This needle often has a
removable outer and inner cover. Both covers need to be removed before the
injection.
-
Safety pen needle. This needle has a
removable outer cover. The inner cover is a fixed safety shield that is not
removed. Instead, the shield will be pushed back. This will expose the needle
as the injector is pressed against the injection site.
-
When you get a new box of needles, always check to see what
kind of needle it is. It might be different from what you are used to. If you are
not sure how to use the new needles, talk with your healthcare provider.
Storing insulin
-
Keep insulin you are not
using in the refrigerator. Make sure it is never frozen.
-
Use insulin before it goes
bad (expires). For pen users, the expiration date is usually on the box.
-
Use insulin within 28 days of
opening it
-
Carry your insulin in a bag
made to protect it from heat and cold.
Injection spot
It's up to you to find the best
spot (site) to inject insulin. When choosing a site, keep these facts in mind:
-
You can inject insulin in the
back of your arms, buttocks, the top or sides of your thighs, and your belly
(abdomen). Stay at least 2 inches away from the bellybutton (navel).
-
Insulin works fastest when
injected into the belly.
-
You need to change injection
sites often. Leave about 1 inch between injection sites.
Giving yourself injections
You don't have to give yourself
injections until you are ready. Tell your parents or your healthcare provider, nurse,
or
diabetes educator how you're feeling. They will support you and help you. And, when
you
do decide to start giving yourself insulin, they will continue to help you.
To learn more
Still have questions about
diabetes? Try these websites: