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From Westfield, Indiana, USA:

My three year old, diagnosed with typeá1 diabetes about a year ago, developed hypertrophy in his arms and thighs even though we have rotated injections from site to site from the beginning. I'm afraid I'm not very good at rotating within a particular site-- i.e., different areas on the same thigh. He struggles a lot, and it's hard to see where I'm aiming. Can you recommend any books that deal with this problem in detail?


I don't think that books are going to help. The answer, as you point out, is to distribute injection sites widely, but obviously his struggles are making this very difficult, and it doesn't thelp to say that some children are more susceptible to lipohypertrophy than others. My suggestion would be to see if without using restraint you can get him interested in a new toy, a story or some other distracting activity while you quickly do the injection. It seems to be the restraint that three year olds dislike so much. Certainly though, it would help to talk to the medical social worker on your son's diabetes team about this because, if they are experienced, they can often remedy the needle phobia very quickly.


[Editor's comment: The problem you describe is very common in children of this age. If you are not using it already, you might try using the Inject-Ease which works very well for small children. You might also ask your son's doctor to prescribe EMLA Cream that will numb the injection site, so that perhaps he won't struggle too much.

I would also recommend using a reward system for not fighting the shot. Try not to focus (although, I know it is difficult) on his "bad" behavior as this reinforces it, and often children this age will seek attention of any kind. You might also try play therapy using a large syringe for painting, giving a stuffed animal a shot, etc. If you are uncertain as to how to do this, you might ask your diabetes team for a referral to a play therapist. Play therapy can be of great help.

We find that much of this is behavioral. It will go away in time. SS]

Original posting 30 Jun 2001
Posted to Blood Tests and Insulin Injections


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Last Updated: Tuesday April 06, 2010 15:09:22
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