Easing Injections (Shots), Insertions (Site Changes) and Finger Pokes for Type 1 Diabetic Kids

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Multiple Daily Injections (MDI) with a syringe, insertions from pump site changes, Continuous Glucose Monitoring (CGM) insertions, and finger pokes are sometimes mentally hard for kids. The anticipation when getting an injection or insertion is sometimes worse than the actual pain.

Tips / Products / Prescriptions

Tips

  • Be Ready – minimize the amount of time spent giving injections by having the insulin, site change supplies, CGM parts, and lancets ready. Try to prepare these items out of sight.
  • Make Shots/Insertions “Fun” (or feel some control) – let kids select the syringe, choose the location for the injection/insertion, press the plunger on the syringe, read the glucose meter results or have them put items in the sharps container.
  • Stuffed Animal – let kids give Rufus the Bear or another stuffed animal a shot at the same time with a toy syringe.
  • Reward System – create a reward system for every injection, insertion, or finger poke. Rewards can include:
    • Hugs
    • Reading a book afterwards
    • Fun Band-Aids
    • Sticker chart/shot chart and when full or after a successful streak a treat/toy is received
    • “Brave Box” with treasures/poke prizes
    • Earn “brave bucks” that are used towards a big ticket item like a trip to Disneyland or an expensive toy
    • One-on-one time with Mom/Dad at the park
    • Find your child’s “currency” and use it to your advantage
  • Diabetic Buddy – sometimes kids just need to talk to someone else going through the same thing. Get in contact with another diabetic kid around the same age that has mastered injections/insertions/finger pokes.
    • Meet in person, via Skype, or FaceTime
    • Pen Pals
  • YouTube – search for videos showing kids receiving injections, giving themselves injections, changing pump sites, checking their blood sugar with a glucose meter, OminPod and CGM insertions and generally taking care of their diabetes. Watching a few videos may help.
  • Distractions – provide kids with a distraction that helps take their mind off the syringe/injection/insertion/finger poke.
    • Stress toys or fiddle toys (batons with glittery water, fidget spinner, squishy ball)
    • Watching a video or TV. Consider wearing headphones to avoid hearing priming of pumps and injection noises.
    • Ask kids to wiggle their toes as fast as they can or hold their nose. These actions tend to not allow you to think about anything else.
    • Sing a song
  • Cough at Insertiontheory that coughing at time of needle/cannula insertion provides a distraction that momentarily increases blood pressure reducing pain perceptions.
  • Breathing/Meditation – find a breathing technique that simulates relaxation. Breathing out as the needle/cannula is inserted into the body helps relieve pain.
  • Cold Object – use ice or freeze a spoon/smooth rock and place it on the skin for 2 minutes to help numb the injection site.

Products

Prescriptions

  • Needle Size for Injections – needle size refers to both the length and gauge (thickness) of the needle. Use the smallest gauge needle possible. Also consider if the pen or syringe is a better delivery method. Some kids find the pen less intimidating and less “shot like”.
    • Smallest size for syringes is 6 mm
    • Pen Needles smallest size is 4 mm
  • Finger Pokes Lancer and Lancets – look for a lancing device that offer options for changing the depth of penetration of the lancets and use the thinnest gauge lancets:
    • 28 gauge is the thickest needle (hurts more)
    • 30 gauge needle
    • 33 gauge is the thinnest needle (hurts less)
  • i-Port Advance – an injection port that is inserted once and worn for 3 days. Injections are given via the port with no pain. This prescription medical device helps reduce anxiety with syringes and pain experienced with injections.
  • Insulin Pumps – receiving insulin from a pump replaces the need for multiple daily injections (MDI) at meal times and injections of long acting basal insulin. There are two types of pumps:
  • Topical Anesthetic Creams – cream that temporarily numbs the skin of the injection/insertion site. Also available over the counter:

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