Background: Type 1 diabetes is characterized by deficiency in insulin because of the 
autoimmune destruction of pancreatic β-cells. Children with type 1 diabetes require lifelong 
insulin therapy. Non pharmacological methods as Buzzy Bee and Shot Blocker used to reduce 
children's pain and anxiety. Aim: the present study was aimed to evaluate the effect of shot 
blockers versus buzzy bee distractor on relieving pain and anxiety during insulin injection 
among children with type I diabetes. Research design: Randomized controlled experimental 
study design was used. Subjects: Simple random sampling of 90 children with type 1 
diabetes from Pediatric Endocrinology Unit of Tanta Main University Hospital was recruited. 
Tools: three tools were used, Tool (I): Child's Medical History, Tool (II): FLACC Pain 
Scale and Tool (III): Visual Facial Anxiety Scale. Results: The mean scores of FLACC Pain 
Scale and Visual Facial Anxiety Scale was lower among children in Buzzy Bee group 
compared to other groups during insulin injection. High statistically significant correlations 
were found between level of pain and anxiety throughout the study period. Conclusion: Both 
Buzzy Bee and Shot Blocker had a positive effect on the reduction pain and anxiety for 
children with type1 diabetes. Buzzy Bee was more effective than Shot Blocker. 
Recommendations: Implementation of pain and anxiety assessment must be integrated into 
the routine assessment as vital signs when caring for children. Developing Educational 
programs for pediatric nurses about non-pharmacological techniques including shot blocker 
and buzzy bee to minimize procedures associated pain and anxiety.