Insulin is a hormone that people use to treat diabetes. Mixing types of insulin can give certain people better control of their blood sugar levels.
Hyperglycemia is when a person has high levels of blood sugar. Without treatment, hyperglycemia can be life threatening.
A person who has diabetes has an issue with how their body uses insulin. This means that a person with diabetes may need to have shots of insulin to maintain normal blood sugar levels.
Mixing insulin can help control blood sugar in certain people who have diabetes.
Read on to learn more about mixing insulin, including how to do it and different types.
Self-mixing insulin allows a person to adjust the levels of different types of insulin that they receive. This can allow a person to have greater control over their blood sugar levels.
A person may find that mixing insulin is beneficial to them if they:
- have regular mealtimes
- want to be able to adjust the levels of the different insulins they receive as required
- prefer only to take two injections per day
Self-mixing insulin requires a person to inject themselves with two types of insulin in one injection.
The types of insulin people can use are intermediate-acting insulin and short- or rapid-acting insulin. These insulins take different lengths of time to work, helping a person’s blood sugar levels to remain steady throughout the day.
A person can mix the two insulins in the following way:
- Draw the short- or rapid-acting insulin into the syringe first. This insulin is clear.
- Before drawing the cloudy intermediate insulin into the syringe, roll it gently between the palms 10–20 times. This helps to mix the insulin suspension gently.
- Once the cloudy insulin is mixed, draw it into the syringe with the clear insulin.
- Inject the insulin mixture immediately.
How will a person know how much of each type of insulin to use, and what are the standard doses?Anonymous
A healthcare provider will advise on specific insulin dose recommendations.Marina Basina, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
A person can follow these instructions to inject insulin:
The injection kit
Checking the insulin
- Double-check the expiration date, and throw it away if it is expired.
- Ensure that there are no clumps in the bottle. Throw the insulin away if clumps are present.
- Leave the insulin for 30 minutes to get it to room temperature if it was in the fridge or a cool bag.
- Double-check the healthcare professional’s instructions regarding dosage.
- Wash the hands.
- Pick an injection spot, clean it using an alcohol wipe, and wait for the area to dry. Do not blow on it to dry it more quickly.
- Roll the vial of cloudy insulin between the palms 10–20 times.
- Remove the cap from the cloudy insulin and wipe it with an alcohol wipe. Set the vial on a flat surface.
- Pull air into the syringe. Insert the needle into the vial, then press the plunger down. This will push air into the vial, creating pressure that helps draw the insulin into the syringe.
- Remove the needle from the vial of cloudy insulin without drawing any in.
- Remove the cap from the vial of clear insulin and wipe it with an alcohol wipe. Set the vial on a flat surface.
- Pull air into the syringe to the level that will later fill with clear insulin. Insert the needle into the vial of clear insulin, then press the plunger down.
- With the needle inside the vial of clear insulin, turn the vial and syringe upside down. Draw out the amount of clear insulin required.
- Remove the needle from the clear insulin vial.
- Insert the needle into the vial of cloudy insulin. Turn the vial and syringe upside down, then draw out the required amount of cloudy insulin.
- Tap the syringe to remove air bubbles, making sure not to allow the needle to touch anything.
- Pinch an area of flesh around the injection site. Bring the needle down into the skin at a 90-degree angle, being careful to avoid the muscle.
- Let go of the skin and push down the plunger of the syringe smoothly.
- Wait for around 10 seconds before withdrawing the needle.
- Remove the needle at the same angle as the angle of insertion.
- Carefully dispose of the syringe and needle in a sharps container. Never use a needle or syringe more than once.
Note: If there is a small amount of insulin leak or blood at the injection site, press down on the area using a cotton ball or wipe. Consult a healthcare professional if swelling develops repeatedly.
Premixed insulin is a pre-prepared mixture of different insulins. Premixed insulin generally contains 70–75% intermediate-acting insulin and 25–30% short- or rapid-acting insulin.
A person may prefer to use premixed insulin if they:
- find it difficult to measure and draw up the insulin themselves
- prefer the convenience of a premade solution
- have variable eating and exercise patterns
However, a person is unable to adjust premixed insulin. This means that if a person increases their pre-dinner dose of premixed insulin to offset high blood sugar levels before going to bed, they are at risk of overnight hypoglycemia. Hypoglycemia is when a person’s blood sugar levels drop too low.
A person should store their insulin in a refrigerator. They may want to let their insulin warm up at room temperature before injecting it. People should avoid storing insulin in the freezer as this can damage the insulin.
Once opened, a vial of insulin can last for around 28 days at room temperature.
Different types of insulin may require different storage instructions. A person should discuss storage instructions with a healthcare professional.
A person should not use insulin that has passed its expiry date.
There are several different types of insulin, including:
- Rapid-acting insulin: This form of insulin starts to work around 15 minutes after injection. Rapid-acting insulin peaks after about 2 hours and can last between 2–4 hours.
- Short-acting or regular insulin: Short-acting insulin takes around 30 minutes to work. It peaks 2–3 hours after injection and lasts 3–6 hours.
- Intermediate-acting insulin: This insulin takes around 2–4 hours to work. It peaks after 4–12 hours and can be effective for around 12–18 hours.
- Long-acting insulin: This form of insulin reaches the bloodstream after several hours. Long-acting insulin can work for up to 24 hours after injection.
- Ultra-long-acting insulin: This insulin reaches the bloodstream in 6 hours and does not peak. It can last up to 36 hours after injection.
Information from the American Diabetes Association suggests that, on average, a person with diabetes spends $9,601 per year in medical expenses related to diabetes.
A person who does not have insurance, or is struggling to pay for diabetes treatment, may find the following resources useful:
Mixing insulin can be an effective way for a person to control their blood sugar levels. However, if a person does not have regular mealtimes, mixed insulin may not be right for them.
A person should speak with a doctor before using mixed insulin. A person should also speak with a doctor about what dose of each insulin to use.
If a person is having trouble affording treatment for their diabetes, several resources can help them.