Islets of Hope treatment options for persons with diabetes
Compiled by Lahle Wolfe
Comfort Links for Children with Diabetes
Teddy Bears Teach Tots - Diabetes Health on helping children deal with shots.
JDRF link to books about diabetes and children, including taking shots.
Live and Learn with Diabetes: Educational Toys and Products for Kids
Bearing with Type 1 Diabetes. An article about Rufus and Ruby, teddy bears that bring comfort to children with diabetes. The bears were even launched into orbit aboard the space shuttle Atlantis!
Helping Your Child Manage Type 1 Diabetes. An article on children with diabetes by Brighmas and Women's Hospital.
Gary Scheiner, CDE
Links to Insulin Injection Tips
"As a young Internist, this book proved to be essential in my understanding of diabetes. Searching through my more commonly used references to include Internal Medicine and Endocrinology Textbooks I was unable to find a concise summary of the information and recommend- ations necessary to manage my patients with pumps. The 500 rule and the 1800 rule were just vague concepts found in obscure manage- ment articles and discussions with other providers. I did not have the benefit of a certified pump trainer or diabetic nurse educator. But with this reference as a guide I was able to develop a management plan. In 3 short months I dropped my patient from a HgBA1C of 9.4 to 6.3." IOH Rating 5/5
Smart Pumping integrates this new successful technology with the physical and psychological aspects of diabetes care, and helps patients adopt the insulin pump into their self-care regime.
This book combines a comprehensive medical approach toward intensive diabetes management and pump therapy with a patient-centered appreciation of the real-life challenges and frustrations.
Howard Wolpert, M.D., is an instructor in medicine at the Harvard
Medical School Joslin Diabetes Center and is also in charge of the pump clinic
there. He has written extensively on the use of insulin pumps.
main Treatment Options page
Conventional insulin shot therapy
Mini Site Index
What is Insulin Shot Therapy?
Insulin shot therapy simply means that you administer insulin via a syringe or insulin pen.
Only your doctor can tell you what type of insulin is best-suited for your needs and lifestyle, how much to take, and when to take it. It's important to get and use the exact type of insulin your doctor prescribes because insulin can vary in strength and speed and how and when you take it depends on many factors.
In the United States, insulin is made from pork or is synthesized to be identical to human insulin. Its strength is measured by its concentration. The most common strength is 100 units of insulin per milliliter; it is known as U-100 insulin. On occasion, people who need to take very large or tiny doses of insulin may be advised to use other strengths (such as U-500 or U-10).
Insulin comes in four different speeds:
The faster-acting insulins begin lowering blood glucose more quickly after injection than the slower-acting insulins, and they continue working for a shorter amount of time. Some insulins last for only two hours, while others can last for an entire day. Many people on shot therapy take more than one kind of insulin each day.
See "Types of Insulin" and for more detailed information about kinds of insulin and how each one works.
When choosing a syringe, there are four things to consider:
Your doctor can help you choose a syringe that's designed for the insulin strength that you use as well as the needle gauge (children often need smaller gauge needles for comfort). For example, if you use U-100 insulin, use U-100 syringes; otherwise, you will inject the wrong amount of insulin.
Common syringe capacities in cubic centimeters (cc) are:
Choose the smallest syringe barrel that can hold the total insulin dose you need to take. This will make reading the unit increments on the syringe barrel easier.
Syringe and Insulin Pen Needle Gauges
Needle gauges range between 27 and 31. The higher the gauge, the thinner the needle. Pick a needle gauge that feels most comfortable for you. Needles also come in different lengths, such as 5/16 inch and 1/2 inch. Some insulin pen needles are as short as 1/3 inch. Insulin needles are short to help prevent insulin injections from going in too deeply. Ask your doctor which length needle he/she recommends for you.
Other Insulin Delivery Devices
See, "Insulin Delivery Devices" for more detailed information.
For people who don't want to use a syringe (or those who have trouble such as visually impaired individuals or persons with arthritis), there are a number of alternative insulin-injecting devices. People who need to take insulin at work, school, or when traveling may want to use an insulin pen. Each pen is about the size of a Magic Marker, contains a small cartridge of insulin, and uses a disposable needle. Pens are available in different types and styles and are easy to carry in a purse or pocket. Pens are simple enough that even young children, when properly trained and supervised, can use them with ease.
Another way to take insulin without a syringe is to use an insulin pump. About the size of a pager, a pump delivers a continuous supply of insulin through a small tube and a needle, which is usually inserted into a person's abdomen. Pumps work well for people who take multiple doses of insulin each day but they are not ideal for every person with diabetes.
Yet another option is a spray injector, which uses high pressure to "spray" insulin in a fine stream through a person's skin without a needle.
Step-by-Step Guide to Preparing Insulin for Injection
Although alternatives exist, injecting with a syringe is a fundamental skill in insulin management. Even people who use an insulin pump, insulin pens, or a spray injector may occasionally need to inject with a syringe. Knowing how to use a syringe carefully and consistently can prevent costly mistakes such as incorrect doses, damaged needles, and wasted insulin. Here's how it's done:
Basic Shot Preparation
It helps to have all your supplies ready to go in one place. Wash your hand thoroughly to prevent contaminating needles and insulin. Warm, soapy water is best. Using friction (rubbing hands and fingers together vigorously) will kill more germs than rinsing or passive hand-washing.
Check Your Insulin Carefully
Bad insulin can lead to high blood glucose levels. Insulin does not have to be kept refrigerated but it lasts longer when it is. All insulin should be discarded after the expiration date or 30 days after it was opened and pierced with a syringe, whichever is sooner. Insulin that has been frozen or exposed to any heat source should also be thrown out.
Insulin types that should look clear, like water:
Never shake insulin as it will create air bubbles and you won't be able to fill your syringe right away. If you drop the bottle, or it does get shaken violently, throw it away because this type of action can destroy insulin.
Prepare Syringe & Draw up Insulin (Single Insulin Injection)
Preparing a Mixed (Insulin) Injection
Many people with diabetes take two types of insulin. One to cover meals and another for background (basal) insulin. Sometimes you have to take two separate shots because not all insulin (like glargine) can be mixed with others. However, some insulins can be mixed together into one shot.
If you mix two different insulins in one syringe:
If the bottle of fast-acting insulin, such as Regular, were to get contaminated with slow-acting insulin, such as NPH, the insulin will not work as quickly as it usually does. If you accidentally do the mixing backwards, call your doctor to see if you need to throw out the contaminated insulin bottle.
The first several steps for preparing a mixed injection are similar to those for preparing a single dose. Organize your all your supplies, wash your hands in warm, soapy water, clean the tops of both insulin bottles with an alcohol swab, and prepare your syringe as outlined above.
Following the detailed guidelines above for injecting single insulin (for injecting air, drawing insulin, and removing air bubbles):
Your total dose in the syringe should now equal:
faster-acting dose + slower/longer acting dose = total dose in syringe
You did it! Now the syringe is now loaded and ready to inject. On to "How to Inject Insulin"
Note: If you are using an insulin pen for injections, please see our section on "Insulin Pens" for information about the types of pens available and the advantages and disadvantages of insulin pen use. You can also read "Step-By-Step Guide to Injecting with Insulin Pens."
On to "How to Inject Insulin"
Page Updated 03/12/2006