Video Study Guide
Insulin Administration
This study guide is intended to be a general guide that will help you understand the key
elements of this video. Each diabetes camp operates under detailed policies and
procedures that follow Board of Health and national accreditation standards that ensure
the health and safety of children with diabetes. It is essential that camp staff familiarize
themselves with the policies and procedures specific to the diabetes camp at which they
will work or volunteer, ask questions and use good judgment as they provide diabetes
management supervision and educate youth with diabetes at camp. While doing so, it is
equally important that camp staff not lose focus – camp is a place for youth to have fun with
peers – to feel supported and understood, and to feel part of a passionate community.

Campers arrive at camps on all methods of insulin delivery – injections, insulin
pumps, insulin pens. They are also on many different insulin regimens. It is
important to accept each camper’s method and to help them better understand it,
not to judge it. The important message for campers is that insulin is good and all
delivery devices are “cool” as long as you take your insulin.

Insulin administration at camp varies greatly from insulin administration at home
or in a clinical setting. It also varies from camp-to-camp, so it is very important to
become familiar with, and to follow, your own camp’s policies and procedures.

Insulin is generally administered before, during or after meals, according to camp
protocol. It is also administered whenever a “correction dose” for blood glucose
outside the recommended range (on the high side) is needed (again according to
protocol).

Campers arrive at camp on an insulin “regimen” which is followed as much as
possible in the camp setting. Often, basal or long-acting insulin doses will need to be
reduced when campers arrive at resident camps because activity levels tend to be
higher. This will be done by the camp physician. On a daily basis, both at resident
and day camps, insulin doses are adjusted based on blood sugar levels (checked
before each meal and whenever there are symptoms), planned activity, and food
intake.

Some campers are on multiple daily injections of “analog” or fast-acting insulin to
“cover” meals (carbohydrates) and to correct blood glucose readings, combined
with long-acting or “basal” insulin which have a long action time in the body. This
mimics what the body’s own system does when it produces insulin in the pancreas.

Other campers use insulin pumps which infuse analog (fast-acting) insulin through
tubing inserted in the body (back of the arms, tummy, upper buttocks, thighs)
throughout the day in micro units according to pre-set infusion rate(s). In addition,
the pump will give additional insulin (“bolus” dose) as needed to cover meals and
for a correction dose. Campers should never give insulin without the supervision of
a camp staff member as directed by camp policy/procedure.

At most diabetes camps a camp physician reviews all camper blood sugars and
insulin doses and makes recommendations for the next insulin dose. Then, camp
nurses, along with cabin counselors and the campers themselves, work as a team to
discuss and administer insulin after blood glucose checks are complete. This is a
perfect educational opportunity for all staff to interact with campers about insulin
dosing and the effects of food, activity and insulin dose (and other variables like
stress) on blood sugar levels. It is also a great time to show proper methods of care
and to show campers new methods – like the use of insulin pumps for campers who
may not be using them, or insulin pen devices. Many industry partners are willing
to donate or lend equipment to camp so that campers can see devices that they may
not know about. Camp is a great opportunity for campers to make informed
decisions about their own care once they go home.

Camp is a good place to encourage campers to take the next step in independence –
whether it’s pushing buttons on the pump or giving their own shot for the first time.
Peer and professional support in a relaxed and supportive environment can work
wonders for even the most timid youngster.

Another important teaching opportunity is site rotation - whether it is injection sites
or pump sites. Tissue buildup can lead to absorption difficulties and encouraging
campers to rotate sites when their peers are “rotating” too can be much easier than
battling at home with parents.

Documentation of all blood sugar readings, insulin administration, hyper (high) and
hypo (low) blood sugar and any treatment given needs to be recorded so that the
camp physician has adequate information on which to base the next insulin dose.
Following camp procedure for documentation is essential.

If possible (depending on facility) unopened insulin should be stored in
refrigeration. Opened insulin bottles and pens for current day’s use can be stored
with health care supplies and in belt/backpacks as needed. In extremely hot
environments it may be necessary to use a cool pack.

Diabetes supplies must always accompany campers whether they are in camp or out
of camp on a field trip. Campers should never have to walk to the health care center
or search out treatment for low blood sugar. Staff should be equipped on site “at the
ready.” Treatment for low blood sugar may be handled at the activity so that a
camper may go right back into the activity once blood sugar is stabilized (see video
on blood glucose monitoring for more information).

If insulin regimens are changed (significant changes in basal rates, types of insulin,
etc. not adjustments for daily blood sugar variability) or if there is an injury or
illness, a health care team member should communicate with the parents. If a
camper has to be treated by an off-site medical facility, a health care team member
or staff member should accompany the camper and the parents should be notified.

For detailed information on diabetes, blood glucose monitoring and insulin
administration, please go to our “Downloads” section and select “Diabetes 101”