Understanding Your Child’s Diabetes: What Are Insulin and Glucagon?

Your child’s hormones are always at work. They tell each part of their body — from their skin to their heart and kidneys — what to do and how to do it. They’re essential to health and wellbeing, but when your child has diabetes, some of these hormones don’t work as they should.

Insulin and glucagon are two hormones that play an important role in your child’s blood sugar levels. Insulin is a hormone that lowers blood sugars by moving sugar out of the blood and into the cells of the body for energy. It’s produced in the beta cells of the pancreas.

Glucagon is a hormone that’s produced in the pancreas by the alpha cells. It acts as a messenger in the body to release stored sugars from the liver.

Your child’s physician may prescribe injections (shots) of these hormones to help you manage your child’s diabetes. Here’s what you should know about using insulin and glucagon.

Insulin: Usage, Storage and Additional Tips

There are several different types of insulin with different actions:

How to Use Your Child’s Insulin

Initially, the child’s doctor will decide your child’s insulin dose. The time it is given depends on the type of insulin:

• Lantus/Basaglar/Levemir must be given at the same time every day. Tresiba works best when given at the same time every day.

• Humalog/NovoLog/Apidra work best when given before a meal. Do NOT give more frequently than every 2.5 hours.

When you store your child’s insulin:

• Keep insulin from extreme heat or cold temperatures (should be 40-85 ̊F). Insulin will not be effective if it freezes (even slightly).

• Store unopened insulin in the refrigerator.

• Don’t use unopened insulin past the expiration date on the bottle/pen/cartridge.

• Store opened vials on insulin in the refrigerator or room temperature. (Be consistent with temperatures — don’t switch back and forth.)

• Don’t store opened non-disposable pen devices that use cartridges in the refrigerator.

• Mark opened insulin with the date it was opened and use it for no more than 28 days. Levemir is good for 42 days once opened. Tresiba is good for 56 days once opened.

Don’t use the insulin if:

• It is cloudy, frosty in appearance or if solid particles can be seen.

• The expiration date on an unopened bottle/pen/cartridge has passed.

Other Things to Keep in Mind About Your Child’s Insulin

• Always communicate that the insulin is measured in “units” to make sure the proper dosage is used.

• To avoid errors in giving your child the wrong insulin, put a rubber band around the rapid-acting insulin.

• Be sure to check the manufacturer and type of insulin before leaving the pharmacy to make sure it is the same as what you have been using.

• If blood sugars are highly erratic without any clear reason, start a new bottle.

• Don’t mix or dilute Lantus, Levemir or Tresiba insulin in the same syringes with any other insulin or diluent.

• Always have back-up bottles of insulin available, but try not to open more than one bottle at a time to avoid confusion.

• It’s a good idea to keep insulin in an insulated pack when you are away from home. (See Diabetes and Travel Teaching Sheet.)

• Never use insulin that has not been prescribed by your physician. There are several different concentrations of insulin, and this could be dangerous for your child.

Insulin: A Guide to Subcutaneous Injections and Insulin Pens

In order to give your child insulin, you’ll do it through an injection (shot) or an insulin pen. It’s important to give these shots properly to keep your child safe and healthy.

Insulin shots are given just below the outer layer of your child’s skin (subcutaneously). The amount of medications for subcutaneous shots is small — no more than 1 mL (milliliter).

Remember — insulin pens are for individual use only, and they are not to be shared.

Glucagon: Usage and Additional Tips

Give a Glucagon injection or Baqsimi (glucagon) nose spray when your child’s low blood sugar causes seizures (uncontrolled movements), if your child is unable to wake up or if your child is unable to drink safely. When in doubt — give glucagon!