Which insulins can be mixed together

Long-acting insulin glargine is also available in U This is three times more concentrated than U long-acting insulin.

Be sure to check the concentration of your insulin so you take the right amount. Rapid-acting insulins work over a narrow, more predictable range of time. Because they work quickly, they are used most often at the start of a meal.

Rapid-acting insulin acts most like insulin that is produced by the human pancreas. It quickly drops the blood sugar level and works for a short time.

If a rapid-acting insulin is used instead of a short-acting insulin at the start of dinner, it may prevent severe drops in blood sugar level in the middle of the night. Short-acting insulins take effect and wear off more quickly than long-acting insulins. A short-acting insulin is often used 30 minutes before a meal so that it has time to work. These liquid insulins are clear and do not settle out when the bottle vial sits for a while. Intermediate-acting insulins contain added substances buffers that make them work over a long time and that may make them look cloudy.

When these types of insulin sit for even a few minutes, the buffered insulin settles to the bottom of the vial. Mixtures of insulin can sometimes be combined in the same syringe, for example, intermediate-acting and rapid- or short-acting insulin. Not all insulins can be mixed together. For convenience, there are premixed rapid- and intermediate-acting insulin.

The insulin will start to work as quickly as the fastest-acting insulin in the combination. It will peak when each type of insulin typically peaks, and it will last as long as the longest-acting insulin. Examples include:. Author: Healthwise Staff. Medical Review: E. This information does not replace the advice of a doctor. If refrigeration is not possible, it can be kept at room temperature [ degrees C] for 28 days. Insulin has a 'use by' date as well as an expiry date.

Do you shake insulin? The insulin should not have any clumps on the sides of the bottle. Intermediate-acting insulin N or NPH is cloudy, and must be rolled between your hands to mix it. DO NOT shake the bottle. This can make the insulin clump. Why do you mix insulin clear to cloudy? Inserting the needle into the cloudy insulin bottle Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle.

If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle. How long can insulin be unrefrigerated before it goes bad? What happens if you use bad insulin? Using insulin past the manufacturer's expiration date can cause your blood glucose to be higher than expected if you stick to the same dosing you've been using all along. High blood sugar can cause symptoms like thirst, fatigue, blurry vision and a frequent need to urinate.

How do you travel with insulin that needs to be refrigerated? To store your insulin properly and keep it cool, you need: Insulated cooler bag. Reusable ice gel packs. How to keep insulin cool while you travel? Store the refreezable ice gel pack in the pouch compartment. The long acting insulin analogs are suitable for background or basal insulin replacement. It is important to take insulin detemir and glargine at the same time s every day to maintain the most predictable levels of basal insulin.

Insulin glargine forms clusters when it is injected under the skin. As the individual insulin units detach from the cluster, the insulin analog can be absorbed into the blood stream.

The slow break-up of the insulin cluster gives insulin glargine its long action. After insulin detemir is absorbed into the blood stream, it becomes attached to a blood protein, albumin. It slowly detaches from the albumin over the next hours. Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Treatment of Type 1 Diabetes , take our self assessment quiz when you have completed this section.