Insulin Injections

Kimmy Sue has Type 1 Diabetes so she is insulin dependent. This means that whenever she eats something (unless it’s a 15 carb snack) she has to take insulin in order for her body to be able to use the energy the body makes from it.

Kimmy has to inject two types of insulin. When she eats we use Humalog which is a rapid acting insulin. Rapid acting insulin begins its work almost immediately. It works for three – four hours. It’s also what we use to bring high blood sugar down. Rapid acting insulin has to be calculated so we do not give the same dose every time we take it. The calculation is based on how many carbohydrates Kimmy Sue has eaten and blood sugar level. We give one unit of insulin for every twenty carbs she eats. On top of that she gets one unit of insulin for every 50 over 150 of blood sugar. So, if she eats 80 grams of carbohydrates for dinner we divide that by 20 so she would get four units of insulin for carbohydrates. If her blood sugar is 190 (which is high for Kimmy and a number we wouldn’t want to see – the doctors want her blood sugar to be between 80 and 180) then we would add one unit of insulin for blood sugar. That would bring her dosage of insulin for that meal up to five units of Humalog. If her blood sugar is below 80 we subtract one unit from the dosage. So using the example above if her blood sugar were 74 instead of 190 we would subtract a unit so the dose would be three units of insulin instead of four. We give this injection in her upper arm and we alternate the arm each day as well as the injection site in order to not build up calluses.

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At night, before bed we inject Lantus which is a long acting insulin. This insulin provides a basal dose of insulin for 24 hours. This dosage is always the same. Kimmy gets seven units of Lantus every night before bed. We give her Lantus in her tummy. We alternate the site of injection so she doesn’t build up calluses but it’s not easy finding a new site each night. We’ve tried using the leg as well but Kimmy doesn’t have a lot of what we call “juice” (which really means fat) on her legs.

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We do not mix the types of insulin. This is why we give the injections in different sites.  We use a 31 gauge needle that is 8 mm in length. The higher the number on gauge the thinner the needle. Getting a shot with the 31 g doesn’t hurt at all. I know; when we were in the hospital I gave myself a shot with one. People are always amazed at how easily Kimmy takes her shots. They really don’t hurt but she is amazing.

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She’s really good at taking her blood sugar and her shots. (They told us in the hospital not to call them shots but I think that’s ridiculous. It’s a shot but it doesn’t hurt. We don’t always sugar coat the truth in our house.)  At this point in time Kimmy doesn’t do her own injections.  I have no doubt she is more than capable but she feels a little squeamish about doing it herself.  She does take her own blood sugar but at this point in time she doesn’t do her own injections and I don’t ask her too.  The nurse at school has offered to work with her on it since there are times at school when Nurse Amy is unavailable (the high school doesn’t have a nurse so Nurse Amy does double duty) and she wants Kimmy to be able to administer her own shot.  Both Nurse Amy and I think that Kimmy would be more inclined to do her own shot for Nurse Amy than for me.  Kimmy likes Nurse Amy and wants her to be proud of her.  🙂

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