Starting Insulin in Children With Type 1 Diabetes

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Diabetes is a tough disease for anyone to deal with, but it can be especially difficult for children. Most children are diagnosed with type 1 diabetes which requires insulin therapy. Not surprisingly, most children don’t enjoy the daily injections needed to control their blood sugars. Starting insulin in children with type 1 diabetes is challenging, but most children eventually adjust to their insulin regimen.

Starting Insulin in Children with Type 1 Diabetes is a Necessity

Children with type 1 diabetes cannot be treated with oral diabetic medications and require regular insulin injections instead. This is because children and adults with type 1 diabetes don’t have functional insulin-producing cells in their pancreas, so insulin must be replaced by injection several times a day. In some cases, an insulin pump can be used.

Starting insulin in children with type 1 diabetes is also challenging due to the risk of low blood sugar levels. Unless insulin injections and diet are carefully managed, a child can develop life-threatening hypoglycemia or, at the other end of the spectrum, diabetic ketoacidosis. It can be difficult for a parent to closely monitor a child with type 1 diabetes especially when they enter school. Parents must be aware of the signs and symptoms of hypoglycemia and ketoacidosis, and be prepared to take immediate action if they develop.

Giving Insulin Injections to Children

Starting insulin in children with type 1 diabetes is difficult in the beginning because children generally don’t like needles. It’s best to sit down with a child who’s been newly diagnosed with type 1 diabetes, and carefully explain why he needs regular insulin injections. Don’t hide the fact that the injections may sting a little, but emphasize that the discomfort will be quick, and you’ll try to make it as painless as possible.

There are ways to reduce the discomfort of an insulin injection. One way is to ask your child to cough before sticking him with the needle and again as you place the needle into the arm. Studies show this reduces the discomfort of a needlestick in both children and adults. It also helps to distract a child by talking about something pleasant while preparing for the needlestick.

Another option is to ask your doctor about using a thinner gauge needle. The thinnest available is a 31 gauge needle, which will hurt less than a thicker one but may not be appropriate for a child who’s overweight or has a lot of fatty tissue on their arm. Children who have more fat on their arms should also use a longer needle. Ask your doctor what needle gauge and size is best for your child - to be sure you’re using one that’s appropriate. If your child complains of pain despite all of these measures, try icing the area before an insulin injection to reduce the pain and sting.

Starting Insulin in Children with Type 1 Diabetes: The Bottom Line?

Children are almost never fond of needles, which makes starting insulin in children a challenge - but with a little kindness and patience, your child will soon get regular insulin injections without so much as a tear.


American Medical News. “Kids’ Shots May Hurt Less With “Cough Trick” (

Web Md. “Type 1 Diabetes: Children Living With the Disease - Topic Overview”