Type 1 diabetes in children is a chronic condition that requires lifelong insulin. A diabetes care plan is crucial for keeping blood sugar levels within a healthy range.

With proper management, children with type 1 diabetes can lead active and healthy lives. This article covers how insulin injection works in type 1 diabetes and the different ways that insulin can be administered to children.

Key Information About Children with Type 1 Diabetes

Diabetes mellitus type 1 is a long-term (chronic) condition. It can begin at any age. Type 1 diabetes affects only 5% of diabetics.
Type 1 diabetes is characterized by abnormally high blood glucose levels.
It is most commonly caused by an autoimmune disorder in which the body's immune system destroys insulin-producing cells in the pancreas.
To keep blood glucose levels within normal ranges, children with type 1 diabetes require daily insulin injections.
Blood glucose levels continue to rise in the absence of insulin, and death occurs.
Children with type 1 diabetes can live active, healthy lives with insulin administration and other management activities.

What is a Diabetes Care Plan, and How Does It Work?

A diabetes care plan is a set of guidelines that you and your child must follow. The plan's goal is to keep your child's blood sugar levels within a healthy range.

A diabetes care plan consists of four components:

examining blood sugar levels - With a blood glucose meter or continuous glucose monitor (CGM)
Taking insulin
eating a healthy, balanced diet, and counting carbs
actively involved in regular physical activity

The diabetes healthcare professional will teach you and your child the ins and outs of the plan, as well as how to follow it. There will be a lot to learn at first, but you will quickly become an expert.

What is Insulin

Insulin is a hormone produced by the pancreas that helps your body utilize glucose (sugar) for energy. However, in T1D, the body stops producing insulin, and the missing insulin must be replaced through injections or an insulin pump.

What is insulin made of?

Insulin is manufactured in a wide range of ways-

Human insulin – this is synthetic insulin created in a laboratory to mimic the insulin produced by the body.
Analogue insulin – the insulin molecule resembles a string of beads. Scientists have been able to change the position of some of these beads, resulting in the creation of genetically engineered insulin known as analogs.
Animal insulin – Although it is no longer widely used, some people find that insulin derived from animals works best for them. It is usually derived from a cow or a pig.

Type of Insulin

Children with T1D need insulin for energy
Insulin schedule is personalized by the care team
Clear and cloudy insulin types are available
Cloudy insulin must be rolled before use
Rapid-acting and long-acting insulin may be needed
Unique combinations are required for everyone
Terms to know:
Onset – The rate at which insulin lowers your blood sugar.
Peak Time – The time when insulin is at its strongest.
Duration – The time it takes insulin to lower your blood sugar.

Your doctor will recommend the best insulin or insulins for you based on a number of factors, including:

What level of activity do you have
The food you consume
How well you control your blood sugar levels
Your age

How long your body takes to absorb insulin and how long it remains active. (This varies from person to person.)

Types of insulin are as follows:

Insulin Type

Onset

Peak Time

Duration

Method

Rapid-acting

15 minutes

1 hour

2 to 4 hours

Usually taken immediately before a meal. Frequently used in combination with longer-acting insulin.

Rapid-acting inhaled

10 to 15 minutes

30 minutes

3 hours

Usually taken immediately before a meal. Frequently used in combination with injectable long-acting insulin.

Regular/short-acting

30 minutes

2 to 3 hours

3 to 6 hours

Usually taken between 30 and 60 minutes before a meal.

Intermediate-acting

2 to 4 hours

4 to 12 hours

12 to 18 hours

Covers insulin requirements for a half-day or overnight. Frequently used in combination with rapid- or short-acting insulin.

Long-acting

2 hours

Does not peak

Up to 24 hours

Covers insulin requirements for approximately a full day. When needed, it is frequently combined with rapid- or short-acting insulin.

Ultra-long acting

6 hours

Does not peak

36 hours or longer

Provides consistent insulin over long periods of time.

Premixed

5 to 60 minutes

Peaks vary

10 to 16 hours

Insulin with intermediate and short-acting properties is combined. Typically taken between 10 and 30 minutes before breakfast and dinner.

Insulin Classification and Tips for Injection

Insulin classified based on its duration of action
Rapid- or short-acting insulin lowers blood glucose during meals
Intermediate or long-acting insulin helps manage overall needs
Both aid in controlling blood glucose levels
Cloudy insulin should be gently rolled before injecting
Ensure insulin is evenly mixed until it looks milky
Don't use clear insulin if it appears cloudy

Insulin can be given to children:

Through injection - Every day, children typically require four or more injections. An insulin needle is extremely small, and a shot is not painful. Your child's care team will teach you how to help him or her cope with injections.
Using an insulin pump - The pump continuously injects insulin into the body through a small tube placed just beneath the skin.
Insulin pens - Insulin pens already contain an insulin cartridge.

The healthcare professional will teach you and your child how to use the pump or pen or inject the medication.

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Administering Insulin Injections for Children with Type 1 Diabetes

For children with Type 1 Diabetes, insulin injections are a necessary part of their daily routine. Administering insulin injections to a child with Type 1 Diabetes can be a challenging task, but with the right guidance and resources, it can become a routine part of their care. This guide provides a detailed overview of the materials needed, preparation steps, and injection technique required to ensure safe and effective administration of insulin.

How insulin injection works in T1D

Insulin is produced by pancreatic beta cells, which are destroyed by the immune system in T1D.
Without sufficient insulin, blood sugar levels can rise to dangerous levels, leading to long-term health problems.
Children with T1D need to check their blood glucose levels regularly to maintain them within a target range.
This is typically done by pricking a fingertip and using a glucose meter to read the blood glucose level.
Based on this reading, the amount of insulin required to maintain normal blood sugar levels can be determined.

How to Give a Child an Insulin Injection

Steps for Administering an Insulin Injection:

Materials Needed:

Insulin bottle
Syringe
Alcohol swabs
Container for used syringes

Preparation:

Wash your hands
Inspect the insulin bottle to ensure it is not expired
Take the lid off the insulin bottle
Using an alcohol swab, clean the bottle's rubber top
Take the syringe's cap off
Pull the plunger back until the black tip of the syringe is even with the line indicating the dose needed
Invert the insulin bottle and the syringe
Slowly withdraw the plunger until the top of the blacktip is even with the line indicating your dose

Choosing an Injection Site:

The type and location of insulin injection affects its rate of absorption
Inject insulin just beneath the skin into fat, with abdomen being the most effective site
Other injection sites include back of upper arms, buttocks, and top and outer sides of thighs
Rotate injection sites to avoid problems and allow 1 inch of space between sites
Avoid injecting within 2 inches of the belly button and areas of lipohypertrophy
Inadvertently injecting into a muscle or lipohypertrophy area can alter insulin absorption

Administering the Injection:

Choose a location for the injection and clean the skin with an alcohol swab
Pinch the skin gently
Hold the syringe at a 90-degree angle to the skin and insert the needle completely
Allow the pinched skin to heal before slowly pushing the plunger to inject all of the insulin
Wait about 5 seconds before removing the needle

Note:

This information is for educational purposes only
Consult your doctor for specific instructions on how to administer an insulin injection to your child.

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Insulin & Type 1 Diabetes in Children