Subcutaneous insulin administration in infants and toddlers

Management of diabetes in infants and toddlers requires the administration of multiple subcutaneous insulin injections and frequent monitoring of blood glucose. However, there are significant unique challenges in managing insulin injections in this age group due to unpredictable eating and activity patterns, less subcutaneous fat, increased risk of hypoglycaemia, and the child's inability to communicate symptoms and comprehend the need for insulin. Insulin pumps and pen devices are preferable to insulin syringes. Injection should be administered with smaller and finer gauge needles and care should be taken to ensure correct injection technique to avoid inadvertent intramuscular injection. In this article, we highlight some of these challenges and summarize the strategies to optimize insulin administration in infants and toddlers.