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September 30, 2003

Behavior, Blood Tests and Insulin Injections

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Question from Cumberland, Maine, USA:

Our three year old son, diagnosed with type 1 diabetes last week, has been taking the blood tests quite well (generally offering up a finger), but the shots have been quite challenging. He runs and hides under a table when it’s time for a shot. We try as hard as we possibly can to be positive and light and not make a big deal out of it, but honestly it just rips me up inside to have to get my son out from under a table to give him a shot while he’s crying. Just hearing his little voice say ‘ouch, ouch, ouch’ as he gets the shot and then say he is mad at me and hide afterwards is just a bit tough to deal with.

I know I am helping keep him alive and healthy, and I can handle it, but I was wondering if anyone has some good ideas on how to make it easier. We’re normally a no-TV kind of house, and we’ve tried allowing him to watch cartoons while giving him the shot, but that hasn’t worked. We found a five year old boy who has diabetes and had our son watch him get a shot.

Do you think his fear/panic will pass? Just hearing his little voice say ‘ouch, ouch, ouch’ as he gets the shot and then say he is mad at me and hide afterwards is just a bit tough to deal with.

Answer:

From: DTeam Staff

This is pretty normal behavior for a three year old. He thinks if he complains loudly enough you will stop. Of course, this isn’t possible since insulin saves his life. You cannot rationalize this to a three year old, as you know, but you can do several other things to make this traumatic first few weeks pass:

The key is to get everything ready ahead of time and then not let him run away. He clearly has to learn that running under the table only prolongs the agony so the quicker you jab him and get this over, the better. All the time, keep talking to him in as calm a fashion as possible and pin him down tightly while you tell him you’re sorry, but this is his insulin, and it helps him to be healthier. Don’t tell him it doesn’t hurt, since it does, and tell him you will do it quickly. When it’s over say you’re sorry, give him a hug and a kiss so that he calms down in a few moments. As he learns that he can’t run away or stall, he’ll quickly figure out that it’s better to get it over with quickly!
Distractions like cartoons sometimes work, but it doesn’t seem like this will work in your case.
Another good option is to role play with some favorite stuffed animals or dolls. Let him be you and you be the child-doll-animal. Fuss just like he does and see how he handles this fussing. This may give you a clue. Don’t be surprised if he jabs rather forcefully since that’s how he “feels” you are doing.
There are also some good coloring books and kids story books with diabetes as part of their story line. Ask your diabetes team for some suggestions so that you can read things to him, help him place the testing and insulin injections into some context.

Most important, is to remain in control and get things over with quickly and honestly so that he can learn that this is the new expectation.

SB