Manage Your Child’s Care with MyChart
Learning to draw up and give insulin takes practice. Families often
start by doing "air" shots into a doll for practice. Next they
practice drawing up sterile salt water (saline) and injecting each
other. This helps family members realize that the shot is not very
painful. Children below age 10 usually do not draw up insulin by
themselves as they do not have the fine motor abilities and concern
for accuracy. Your child will need your help.
There are now several brands of disposable insulin syringes with
varying needle widths. Needle thickness is measured in gauges. A
larger number means it has a thinner needle (for example, a 30 gauge
needle is a thin needle). Needles also come in varying lengths. The
standard length is 1/2 inch. Insulin syringes should have thin,
short, sharp needles so they are easy to insert.
The amount of insulin a syringe will hold varies. Insulin is
measured in units. Example of common syringes:
Syringes have markings on the side that measure the units. A 3/10cc
syringe has a larger distance between the unit lines and is easier
to use if you need to measure small doses. There are even some
syringes that have markings for half units. If you do not want to
throw away the syringe after each use, you can reuse it. However,
the needle may get dulled from going through the rubber stopper on
the insulin bottle over and over. A dull needle may cause more
damage to your child's skin and tissues. There is also a possibility
of infection when reusing syringes.
Your healthcare provider will show you how to draw the insulin into
These are the steps:
Continue with steps 8 and 9 if you need to add an
intermediate-acting insulin to the same syringe. If you want to
have both hands free, you can leave the syringe stuck in the
rapid-acting insulin bottle until you have mixed the
One problem with insulin bottles is that a vacuum can develop which
will draw the insulin in the syringe back into the bottle. To avoid
this problem, you can do one of two things:
Venting the bottles
To vent the bottles:
Pick one consistent day of the week to vent the bottles.
Insulin is injected into the fat layer beneath the skin. The best
places to give insulin are the abdomen, arms, thighs, and buttocks.
You should rotate injection sites. If your child doesn't like to
have shots in one of these areas, then you should rotate the shots
between the other areas and skip the area that bothers your child.
Shots should not only be rotated from site to site but also within
the site itself. For example, there might be 6 different places on
the thigh that you can use. This way your child can have a shot in
over 50 different spots, before having to have a shot in the same
place again. For example, see injection rotation chart.
It is important to learn the proper technique. If you give the shot
too close to the outer skin it can cause a lump, pain, or a red
spot. If you give the shot too deep into the muscle it may be more
painful and cause the insulin to be absorbed too quickly. You want
to avoid injecting insulin into a large vein or artery. This is very
unlikely if you are giving shots in the recommended areas. If you
did inject insulin into a large vein or artery, the insulin would
last only a matter of minutes rather than hours. Do not worry about
accidentally injecting a bubble of air into your child (even into an
artery or vein). It will not harm your child.
To inject the insulin:
Ideally, insulin should be stored in the refrigerator and warmed to
room temperature before using. You can warm it up by holding your
filled syringe between your hands for a minute or two. If you warm
the insulin to room temperature, it is less likely to sting or cause
red spots on the skin.
Some people store the bottles they are using at room temperature
(except during very hot summer months). Research has shown that
insulin stored at room temperature loses a small percentage of its
potency every month. For most people, this small change will not
make a difference. Watch your child's blood sugar levels carefully
when the insulin bottle is almost empty. If the blood sugars start
to be unusually high or low, the last bit of insulin should be
Insulin will spoil if it gets above 90� or if it freezes. Insulin
bottles (or pens) should not be left in a car in the hot summer or
the cold winter.
Throw away insulin if:
The plastic syringes are recommended for one time use only. If you
need to reuse the syringe, after giving the injection, push the
plunger up and down to get rid of any insulin left in the needle.
Wipe the needle off with an alcohol swab. Put the cap over the
needle and store the syringe and needle in the refrigerator until
ready for the next use.