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Glucose is the fuel the body gets from food and uses for energy. To use this fuel, your body needs to make something called insulin. The problem is, your body isn’t making the insulin it needs. The missing insulin needs to be replaced. You can’t take insulin as a pill because your stomach will destroy it. So, insulin must be injected into your body. Injecting insulin may seem scary for you at first. But don’t worry, you’ll have help from your parents and your healthcare team. They’ll show you the right way to give yourself insulin injections.
Giving yourself an insulin injection for the first time can be scary. You may be worried that the shot will hurt or you’ll make a mistake. It’s normal to feel nervous about these things. Most people with diabetes are scared to give themselves insulin injections in the beginning. Even your parents were probably nervous giving you your first insulin shot. But after a few times, they got the hang of it. With a little practice, you’ll get the hang of injections, too. And pretty soon you won’t feel nervous or scared at all!
There are many types of insulin. Types you will use are:
Fast-acting insulin. Fast-acting insulin is taken with meals (you have to eat within 15 minutes of taking it).
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.
Sometimes different types of insulin are mixed together and taken at the same time. Your healthcare team will tell you what’s right for you.
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. Most people with diabetes inject using a syringe. Follow these steps for injecting insulin with a syringe:
Step 1: Getting ready
Gather your supplies. Here’s what you’ll need:
A new syringe
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 other adult to supervise
Wash your hands. Use soap and warm water.
Clean the insulin bottle. Wipe the top of the rubber TOP of the insulin bottle with an alcohol wipe.
Prepare the insulin. If you use the cloudy type of insulin (not the clear stuff), roll the bottle gently between your hands about 20 times. Don’t shake the insulin. And don’t use cold insulin. Instead, keep one 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. NOTE: The mark on the syringe nearest the needle is 0 (not 1).
Inject air into the insulin bottle. 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 bottle. (Injecting air makes it easier to draw out the insulin.)
Turn the syringe and bottle 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 in the bottle. You may need to pull the needle out a little. (This is to keep air from getting into the syringe.) Slowly pull back the plunger to draw in the number of units of insulin you want to inject.
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. (Another way to get rid of air bubbles is to slowly push all the insulin back into the bottle and then redraw the entire amount. This time, pull back the plunger even more gently to avoid air bubbles.)
Remove the needle from the insulin bottle.
Step 3: Giving the injection
Clean the injection site. Use an alcohol wipe to clean off the area of skin 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. This is to make sure you don’t inject into a muscle. Injecting into muscle can be more painful.
Insert the needle. Insert the needle into the skin, like your healthcare team showed you. Remember the angle they showed you, too. Push the needle in until you can’t see it anymore.
Inject the insulin. Slowly push in the plunger until the syringe is empty. Count to 5 before pulling out the needle.
Step 4: Removing the needle
Pull the needle from the skin.
Watch the injection site for leaking insulin and blood. If the site bleeds, dab it with a cotton ball or tissue. If insulin leaks, ask your healthcare team to check your injection technique the next time you see them.
Step 5: After the injection
Put the syringe directly in a sharps container. Don’t lay it down anywhere. And don’t recap the needle. Never throw out a syringe in the regular garbage. Someone taking out the trash or picking it up from your house could be stuck by the needle.
Be sure you eat within 15 minutes of injecting fast-acting insulin (the kind used before meals).
You can also use injection pens to get the insulin you need. Injection pens look like pens you use to write with. Just like a regular pen holds ink, insulin pens hold cartridges of insulin. A new needle is screwed onto the pen each time you give an insulin injection. When you give yourself an injection, insulin comes out of the tip of the needle just like ink comes out of a pen when you write. There are different kinds of insulin pens. Your healthcare team will tell you which pen is best for you. They will also show you how to use the pen.
Wash your hands and clean the injection site with soap and water or an alcohol pad before the shot. This helps keep the site from getting infected.
Use a new needle each time you inject.
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 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 three tries, start over with a new needle.
Push the button down all the way. Then count to 10 while injecting the insulin (pens take longer than syringes to deliver insulin).
Cool it, don’t freeze it! Keeping insulin in the refrigerator—and not the freezer—is just one rule for storing insulin. Here are some other rules you must know:
Use insulin before the expiration date on the bottle. Like food, it can go bad! Ask your healthcare team when to throw out open bottles of insulin. (For pen users, the expiration date is usually on the box.)
Carry your insulin and injection supplies in an insulated bag or cooler when you’re away from home.
Don’t let insulin get too hot (above 86°F is bad). And never let it freeze.
Okay, there’s no “X” to show you right where to inject insulin. That’s why it’s up to you to find the best spot. When choosing a site, keep these facts in mind:
Fact #1: You can inject insulin in the upper back part of your arms, buttocks, the top or sides of your thighs, and your stomach. (Stay at least 2 inches away from the belly button.)
Fact #2: Insulin works fastest when injected into the skin of your stomach.
Fact #3: It’s not good to inject insulin in the same site every time. If you do, the skin will scar and become thick, making it harder for insulin to do its job. That’s why you need to switch up injection sites often. Leave about 1 inch between injection sites. And never inject into moles, cuts, scars, or broken blood vessels (purplish bruises).
Fact #4: Injecting into a leg or arm that you plan to exercise is a bad idea. For example, if you run, don’t inject into your legs before you exercise because the insulin will absorb too fast when you run.
If you don’t feel ready to give yourself insulin shots, you don’t have to. Tell your parents or a member of your healthcare team how you’re feeling. They will support you and help you when you do decide to start giving yourself insulin. But until you’re ready, someone else will give you your insulin shots.
Still have questions about diabetes? Check out these websites:
American Diabetes Association www.diabetes.org/living-with-diabetes/parents-and-kids/planet-d
Children with Diabetes www.childrenwithdiabetes.com
Juvenile Diabetes Research Foundation International www.kids.jdrf.org