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Wash your hands.
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Choose the injection site according to
your child’s site rotation plan (see below for more on site rotation).
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Check the insulin carefully. Rapid- and
short-acting insulins should look clear. Intermediate- and long-acting
insulins should look cloudy, with no clumps or crystals. Insulin that
looks different than usual could be too old or spoiled. Throw it out and
start a new bottle.
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Roll intermediate- or long-acting insulin
bottle between your hands to mix the insulin evenly. Don’t shake the
bottle, as shaking can make the insulin clump together. Rapid- and
short-acting (clear) insulin doesn’t need to be mixed.
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Check how many units of intermediate- or
long-acting (cloudy) insulin you need to inject. Then pull back the
plunger to that number of units to draw air into the syringe.
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Hold the intermediate- or long-acting
(cloudy) insulin bottle upright. Push the needle into the top of the
bottle. Push the plunger to put air into the bottle. Take the syringe
out of the bottle.
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Check how many units of rapid- or
short-acting (clear) insulin you need to inject. Then pull back the
plunger to that number of units. Now your syringe has air in it again.
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Hold the rapid- or short-acting (clear)
insulin bottle upright. Push the needle into the top of the bottle. Push
the plunger to put the air into the bottle. Keep the needle in the
bottle.
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While holding the needle in the bottle,
turn the bottle upside-down. Then pull out the plunger to measure out a
bit more rapid- or short-acting insulin than you actually need.
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With the needle still in the bottle (and
the bottle still upside-down), tap the side of the syringe gently. Any
air bubbles will rise to the top. Then push the plunger in just enough
to get rid of the air and the extra insulin. You should now have just
the right amount of rapid- or short-acting insulin in the syringe.
Double-check to make sure, then take the needle out of the bottle.
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Stick the needle in the top of the bottle
of intermediate- or long-acting (cloudy) insulin. Turn the bottle and
syringe upside down. Then pull out the plunger to measure out the exact
amount of intermediate- or long-acting insulin that you need.
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With the needle still in the bottle (and
the bottle still upside-down), tap the side of the syringe gently. Any
air bubbles will rise to the top. If you can get air bubbles out without
pushing out insulin, do so. If there are large air bubbles, you’ll
have to toss the syringe and start over. Pushing out large air bubbles
at this stage will change the insulin dose in the syringe, and injecting
large air bubbles into the body is dangerous.
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Double-check that you have the right
amount of intermediate- or long-acting insulin in the syringe. Then take
the needle out of the bottle.
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With one hand, gently pinch about an inch
of skin at the injection site. Pinching makes sure you don’t inject
into a muscle. Injecting into muscle can be much more painful to your
child, and it changes the amount of time it takes for the insulin to
work.
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With your other hand, hold the syringe
like a pencil. Look at the needle to make sure it’s at angled
correctly for injection. (The doctor or diabetes educator can show you
the correct angle.)
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Gently stick the needle in under the skin
at the correct angle. Press the plunger with your thumb in a gentle,
steady motion until the insulin is gone. Talk to your child about
whether injecting the insulin a little slower or a little faster may be
more comfortable for him.
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When the syringe is empty, pull out the
needle at the same angle you put it in. Press the injection site gently
for a few seconds to prevent the insulin from leaking.
Two types of insulin (mixed)
