5. Insulin injections

Insulin is needed to:

• Replace the insulin that the Islet or Beta cells in the pancreas are not making

• Balance with carbohydrate food that is being eaten

• Bring blood glucose levels down when levels are high, or if you are not exercising or are unwell

Insulin types and dosing regimens: Read about the different types of insulin and insulin regimens. Find out more

For children and young people with type 1 diabetes, insulin injections are needed for life. Young people with type 2 diabetes may also need insulin injections as part of treatment therapy.

Insulin injections can be given with a syringe where two different types of insulin are drawn up and given together in one injection. See the syringe insulin administration chart below.

Drawing up insulin

See the video below to watch insulin being drawn up using a syringe

You can read a transcript of this video here.

Using an insulin pen

Insulin may also be given with an insulin pen device using one type of insulin.

You can read a transcript of this video here.

Premixed insulins are also available. Making adjustments to insulin doses when insulin has been premixed is very difficult. For this reason premixed insulin either via pen device or syringe is used less frequently in children with diabetes during growing years where frequent adjustment of insulin is required.

How often to change the needle

Insulin syringes need to be changed after two injections. For those using twice daily injections at breakfast and dinner, this means changing the syringe each day.

Insulin pen device needles need to be changed after 3-4 injections.

Injecting technique

In children, the skin needs to be pinched upwards to isolate the layer of fat under the skin. A 45 degree angle needs to be used when giving the injection into the layer of fat. Most children do not have much fat when they are diagnosed with diabetes so the safest area to use at this time is the top outside area of their buttocks by their hips. Children with more fat or young people learning to inject themselves can also use the area either side of their tummy button right the way over to their hips.

It is important that injections are given in a different place each time to prevent the development of lumps called Lipohypertrophy which can affect the absorption of the insulin and affect blood sugar levels.

Giving the first injection

Most families find giving an injection for the first time very difficult however over time with a lot of support from your diabetes team, this does get easier.

You can read a transcript of this video here.

Giving an injection to a toddler

You can read a transcript of this video here.

Insulin doses

All parents of children with diabetes and young people who have diabetes need to keep accurate records of the blood glucose levels and how much insulin they have given each day.

In the period following diagnosis families need to stay in daily contact with the diabetes team with these levels so that changes to the insulin doses can be safely calculated. Eventually families develop the knowledge and skills required to manage the insulin doses independently with on-going support from the diabetes team.

You can read a transcript of this video here.

As children grow bigger, insulin doses need to be increased. For older children who are self-injecting, it is important that regardless of age, the injections are closely supervised - this means sitting beside them and watching them draw up the insulin and inject into the layer of fat.

Children with diabetes need to see the diabetes team every 3-4 months so that treatment therapy can be monitored and adjusted.

You can read a transcript of this video here

Disposal of needles

Syringes and pen needles must be disposed of in approved sharp disposal containers. These are available through Diabetes Auckland or your local pharmacy for a small fee. Once the sharps container is full, it must be sealed with the approved lid and returned to the place of purchase for disposal.

You can read a transcript of this video here

Let's go over the main points. Think you've got it sorted? Read through our one page summary here.

Think you've got it sorted now?

If you and your parent/carer have read through the information above and watched the videos, and you feel confident that you can do this yourselves, print off and fill in the evaluation form below (you might need to ask someone to print this off for you) and return to the nurse on your ward. If you have any questions, note them down on this form and your diabetes nurse specialist will discuss them with you.

Insulin injections: Evaluation

After reading this teaching module and watching the videos, I feel confident in:

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