Riley Hospital for Children at IU Health flu-related visitor restrictions have been lifted. However, because babies, especially those who are ill or premature, are at higher risk of serious complications if they get the flu, visitation restrictions are still in place for all Neonatal Intensive Care Units (NICUs) until further notice.
Insulin pens provide a way to deliver insulin to patients with Type 1 diabetes or Type 2 diabetes without using an insulin vial and a syringe. Parents who must give injections to their children and children who give themselves injections often find pens easier to use and more convenient. After adding a pen needle to the insulin pen and turning the dial to the correct dose, you are ready for an injection.
Types of insulin pens include:
Children with Type 1 diabetes use both long-acting and fast-acting insulin pens. Many children with Type 2 diabetes also use insulin pens. Long-acting insulin pens start to lower your child's blood glucose within one to two hours and continue to lower blood glucose for up to 24 hours. Fast-acting insulin pens begin to lower your child's blood glucose within 15 minutes but only last for three to four hours. Some insulin pens are also intermediate-acting, lowering blood glucose within one to two hours and lasting for up to 15 hours.
Most insulin pens are good for 28 days once opened, though some are only good for 14 days. Throw away your child's insulin pen if it froze, sat in a hot car for any length of time or is cloudy or clumped (this does not apply to some intermediate-acting insulin pens). Read your child's insulin pen directions carefully to learn more about how to store the pen and when it expires.
You or your child will follow a personalized insulin regimen that is based on the type of diabetes your child has and his or her individual insulin needs.
The insulin regimen used most often involves checking the blood sugar before breakfast, lunch and dinner. A corrective dose is given at that time to bring down any high blood sugars. A food dose is also given based on the number of carbohydrates eaten. These two doses are combined into one injection.
Snacks high in carbohydrates require a food dose. Your child's blood sugar may not need to be checked at snack times because a corrective dose is not always given with snacks. Corrective doses at bedtime may also be needed if the blood sugar is greater than 250 or 300 mg/dL. Check with your child's doctor to see if he or she needs a corrective dose at snack time or bedtime.
Food and corrective doses are given with fast-acting insulin pens, such as Humalog, NovoLog and Apidra. Fast-acting insulin doses must be separated by at least two hours. If given closer than that, a low blood sugar could result. Blood sugars between meals are controlled by a long-acting insulin pen, such as Lantus or Levemir. Lantus is given once a day at the same time every day. Your family chooses a time that works with your schedule. The dose is the same every day. Levemir can be given once or twice a day at a fixed time with a fixed dose.
Another insulin regimen uses a sliding scale to determine the insulin dose. Use of the sliding scale regimen requires eating a fixed amount of carbohydrates at each meal and snack. Therefore, a food dose is not needed. Blood sugar is checked before the meal or snack, and the insulin dose is chosen from a sliding scale based on the blood sugar. The insulin for the food is built into the scale. The long-acting insulin is still a set amount given at a set time once or twice a day.
At first, insulin regimens can be confusing. Your diabetes educator will explain your child's regimen to you in detail.
Keeping track of your child’s blood sugar is an essential part of managing diabetes. Some parents like using a logbook or software spreadsheet. There are also apps for smart phones that can be used. Below are forms we have created that you can use as well:
Follow the steps below to administer a dose of insulin with a pen:
If insulin or blood leaks out of the injection site or your child experiences pain or bruising, follow the advice below: