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What Insulins Can Be Mixed Together In One Syringe?

Insulin: How To Give A Mixed Dose

Insulin: How To Give A Mixed Dose

Many people with diabetes need to take insulin to keep their blood glucose in a good range. This can be scary for some people, especially for the first time. The truth is that insulin shots are not painful because the needles are short and thin and the insulin shots are placed into fatty tissue below the skin. This is called a subcutaneous (sub-kyu-TAY-nee-us) injection. In some cases, the doctor prescribes a mixed dose of insulin. This means taking more than one type of insulin at the same time. A mixed dose allows you to have the benefits of both short-acting insulin along with a longer acting insulin — without having to give 2 separate shots. Usually, one of the insulins will be cloudy and the other clear. Some insulins cannot be mixed in the same syringe. For instance, never mix Lantus or Levemir with any other solution. Be sure to check with your doctor, pharmacist, or diabetes educator before mixing. These instructions explain how to mix two different types of insulin into one shot. If you are giving or getting just one type of insulin, refer to the patient education sheet Insulin: How to Give a Shot. What You Will Need Bottles of insulin Alcohol swab, or cotton ball moistened with alcohol Syringe with needle (You will need a prescription to buy syringes from a pharmacy. Check with your pharmacist to be sure the syringe size you are using is correct for your total dose of insulin.) Hard plastic or metal container with a screw-on or tightly-secured lid Parts of a Syringe and Needle You will use a syringe and needle to give the shot. The parts are labeled below. Wash the work area (where you will set the insulin and syringe) well with soap and water. Wash your hands. Check the drug labels to be sure they are what your doctor prescribed. Check the expiration date o Continue reading >>

How To Prepare Two Types Of Insulin In One Syringe

How To Prepare Two Types Of Insulin In One Syringe

A step-by-step guide to combine two types of insulin in a single syringe ​People with diabetes may be prescribed two types of insulin to be taken at the same time. To reduce the number of insulin injections, it is common to combine two types of insulin in a single syringe using r​apid-acting (clear) insulin with either an intermediate or a long-acting (​​cloudy) insulin.​ ​ ​ ​​ ​ ​ ​ ​ ​ ​Follow These Steps to Prepare the Injection: Prepare your supplies and remove the insulin vials from the fridge half an hour before your injection. Check their expiry dates. Discard the vial six weeks after opening or as per the manufacturer’s guide. Roll the vial of cloudy insulin (intermediate or long-acting insulin) until the white powder has dissolved. Do NOT shake the vial. Clean the rubber stopper of the insulin vials with an alcohol wipe or a cotton ball dipped in alcohol. Draw air into the syringe by pulling the plunger down. The amount of air drawn should be equal to the dose of cloudy insulin that you require. With the vial standing upright, insert the needle into the vial containing the cloudy insulin. Inject air into the vial and remove the needle. Repeat the steps with clear insulin. Draw air into the syringe that is equal to the dose of clear insulin you require. Insert the needle into the vial containing the clear insulin and inject air into the vial. Do NOT remove the needle. With the needle in the vial, turn the syringe and insulin vial upside down, and draw out your dose of clear insulin. Read the line markings on the syringe to make sure you have drawn the correct amount of insulin. Insert the needle back into the vial containing the cloudy insulin. Do NOT push the plunger. Turn the syringe and insulin vial upside down, and draw out y Continue reading >>

My Doctor Says I Need To Mix Insulins...

My Doctor Says I Need To Mix Insulins...

Mixing Insulins BD Getting Started ™ My Doctor Says I Need to Mix Insulins... How Do I Begin? When your doctor tells you to use two types of insulin for an injection, they can be mixed in the same insulin syringe so that you will need only one injection. Using two types of insulin can help you keep your blood sugar levels in your target range. When you mix two insulins in one syringe, one type of insulin is always clear and short or rapid-acting, while the other type is cloudy and long-acting. Check that you have the right syringe size. Match your dose to the syringe size that is just right for you. It is an easy way to assure the accuracy of your dosage. Two types of Insulin BD™ Insulin Syringe BD™ Alcohol Swabs To mix your insulins, you will need:To mix your insulins, you will need: Also check that you have the right brand and type of insulin. Make sure that the expiration date on the insulin bottle has not passed. Between 30 and 50 units Between 50 and 100 units Use a 3/10 cc BD INSULIN SYRINGE Use a 1/2 cc BD INSULIN SYRINGE Use a 1 cc BD INSULIN SYRINGE Less than 30 units at one time - - - 1 2 3 if you inject:if you inject: ml ml ml 1 2 3 •Roll the bottle between your hands. •Never shake a bottle of insulin. •Wipe the top of both the insulin bottles with a BD™ ALCOHOL SWAB. step one...step one... step two...step two... step three...step three... •Wash your hands. 4 •Pull the plunger down to let _____ units of air in your syringe. •You need air in the syringe equal to the amount of cloudy insulin you will take. step four...step four... 5 6 7 8 •Push the air into the cloudy insulin bottle. •Pull the needle out of the cloudy insulin bottle. •You are not going to draw out any of the cloudy in Continue reading >>

Insulin Injection: Two Bottle Injection Instructions

Insulin Injection: Two Bottle Injection Instructions

Wash your hands. Pick up the CLOUDY bottle and turn it upside down. Roll the bottle gently between your hands to mix the insulin. Wipe the top of both (clear and cloudy) bottles with alcohol. Remove the caps from the top and bottom of the syringe. Pull the plunger down to the correct unit mark for your CLOUDY insulin dose as ordered. Insert the needle into the CLOUDY bottle. Push the plunger down to inject air into the CLOUDY bottle. Withdraw the empty syringe from the bottle. Set the bottle aside. Pull the plunger down to the correct unit mark for the CLEAR insulin dose as ordered. Insert the needle into the CLEAR bottle. Push the plunger down to inject air into the CLEAR bottle. Leave the needle in the bottle. Turn the bottle upside down with the needle in it. Pull the plunger down to the correct unit mark for the CLEAR insulin dose. Look for air bubbles in the syringe. If you see air bubbles in the syringe, push the insulin back into the bottle, and repeat steps 17 and 18. Pull the bottle away from the needle, and set aside the CLEAR bottle. Pick up the CLOUDY bottle of insulin. Turn the CLOUDY bottle upside down and push the needle into the bottle. Be very careful not to move the plunger. Pull the plunger down and withdraw the correct number of units for the CLOUDY insulin. The plunger should now be on the unit mark showing the total units of both the CLEAR and CLOUDY types of insulin. For example, 6 units of CLEAR insulin are already in the syringe. Add 14 units of CLOUDY insulin for a total of 20 units in the syringe. Pull the bottle away from the needle. Set both bottles on the table. Look for air bubbles in the syringe. If you see air bubbles, discard the dose and begin again. Set the syringe down. Do not let the needle touch anything. Pinch or spread the skin a Continue reading >>

Short-acting Insulins

Short-acting Insulins

Rapid-Acting Analogues Short-Acting Insulins Intermediate-Acting Insulins Long-Acting Insulins Combination Insulins Onset: 30 minutes Peak: 2.5 - 5 hours Duration: 4 - 12 hours Solution: Clear Comments: Best if administered 30 minutes before a meal. Mixing NPH: If Regular insulin is mixed with NPH human insulin, the Regular insulin should be drawn into the syringe first. Aspart - Novolog ®: Compatible - but NO support clinically for such a mixture. Draw up Novolog first before drawing up Regular Insulin. Lispro - Humalog ®: Compatible - but NO support clinically for such a mixture. Draw up Humalog first before drawing up Regular Insulin. Mixtures should not be administered intravenously. When mixing insulin in a syringe, draw up the quickest acting insulin first (e.g. draw up Humalog or Novolog before drawing up Regular Insulin, or draw up Regular insulin before Novolin N (NPH) or Lente insulin. CLINICAL PHARMACOLOGY Insulin is a polypeptide hormone that controls the storage and metabolism of carbohydrates, proteins, and fats. This activity occurs primarily in the liver, in muscle, and in adipose tissues after binding of the insulin molecules to receptor sites on cellular plasma membranes. Insulin promotes uptake of carbohydrates, proteins, and fats in most tissues. Also, insulin influences carbohydrate, protein, and fat metabolism by stimulating protein and free fatty acid synthesis, and by inhibiting release of free fatty acid from adipose cells. Insulin increases active glucose transport through muscle and adipose cellular membranes, and promotes conversion of intracellular glucose and free fatty acid to the appropriate storage forms (glycogen and triglyceride, respectively). Although the liver does not require active glucose transport, insulin increases hepatic gl Continue reading >>

Giving Yourself An Insulin Shot For Diabetes

Giving Yourself An Insulin Shot For Diabetes

For those with diabetes, an insulin shot delivers medicine into the subcutaneous tissue -- the tissue between your skin and muscle. Subcutaneous tissue (also called "sub Q" tissue) is found throughout your body. Please follow these steps when using an insulin syringe. Note: these instructions are not for patients using an insulin pen or a non-needle injection system. Select a clean, dry work area, and gather the following insulin supplies: Bottle of insulin Sterile insulin syringe (needle attached) with wrapper removed Two alcohol wipes (or cotton balls and a bottle of rubbing alcohol) One container for used equipment (such as a hard plastic or metal container with a screw-on or tightly secured lid or a commercial "sharps" container) Wash hands with soap and warm water and dry them with a clean towel. Remove the plastic cap from the insulin bottle. Roll the bottle of insulin between your hands two to three times to mix the insulin. Do not shake the bottle, as air bubbles can form and affect the amount of insulin withdrawn. Wipe off the rubber part on the top of the insulin bottle with an alcohol pad or cotton ball dampened with alcohol. Set the insulin bottle nearby on a flat surface. Remove the cap from the needle. If you've been prescribed two types of insulin to be taken at once (mixed dose), skip to the instructions in the next section. Draw the required number of units of air into the syringe by pulling the plunger back. You need to draw the same amount of air into the syringe as insulin you need to inject. Always measure from the top of the plunger. Insert the needle into the rubber stopper of the insulin bottle. Push the plunger down to inject air into the bottle (this allows the insulin to be drawn more easily). Leave the needle in the bottle. Turn the bottle an Continue reading >>

Insulin Types

Insulin Types

What Are the Different Insulin Types? Insulin Types are hormones normally made in the pancreas that stimulates the flow of sugar – glucose – from the blood into the cells of the body. Glucose provides the cells with the energy they need to function. There are two main groups of insulins used in the treatment of diabetes: human insulins and analog insulins, made by recombinant DNA technology. The concentration of most insulins available in the United States is 100 units per milliliter. A milliliter is equal to a cubic centimeter. All insulin syringes are graduated to match this insulin concentration. There are four categories of insulins depending on how quickly they start to work in the body after injection: Very rapid acting insulin, Regular, or Rapid acting insulins, Intermediate acting insulins, Long acting insulin. In addition, some insulins are marketed mixed together in different proportions to provide both rapid and long acting effects. Certain insulins can also be mixed together in the same syringe immediately prior to injection. Rapid Acting Insulins A very rapid acting form of insulin called Lispro insulin is marketed under the trade name of Humalog. A second form of very rapid acting insulin is called Aspart and is marketed under the trade name Novolog. Humalog and Novolog are clear liquids that begin to work 10 minutes after injection and peak at 1 hour after injection, lasting for 3-4 hours in the body. However, most patients also need a longer-acting insulin to maintain good control of their blood sugar. Humalog and Novolog can be mixed with NPH insulin and are used as “bolus” insulins to be given 15 minutes before a meal. Note: Check blood sugar level before giving Humalog or Novalog. Your doctor or diabetes educator will instruct you in determini Continue reading >>

Mixing Insulins In One Syringe

Mixing Insulins In One Syringe

Mixing insulins in one syringe its not hard to learn it just takes a little bit of practice . Once you go through the instructions to mix insulin in a syringe given below, you will find it is a very easy task Example of Dose The doctor ordered 10 units Humulin R insulin and 30 units Humulin N insulin subcutaneously, 30 minutes before breakfast. Since the doctor order, two different insulin preparations to be mixed in the same syringe and your stock is not premixed. They need to be mixed manually in one syringe. Mixing insulin requires extra steps that must be completed in a specific order. 10 units of clear [ R(Regular) insulin] + 30 units of cloudy [N(NPH) insulin] = 40 total units. [Total mixe dose] To administer dose use 50 unit of Lo-Dose syringe How would you prepare to administer this injection? Instructions: Gather all of the equipment you will need Wash your hands Check the expiration date on the vials of insulin. If they are not expired, pick up the cloudy bottle of insulin and roll it between your hands until it is mixed, until there is no powder on the bottom of the bottle. Do not shake the insulin bottle because this can cause air bubbles. Take the bottle of cotton ball dipped in alcohol and wipe the top of both insulin vials Pick the Humulin N (slower acting insulin) first and inject 30 units of air into the vial After putting air in the Humulin N(slower acting insulin) do not draw up the insulin yet,just pull the needle out and insert 10 units of air into the Humulin R( faster-acting insulin) vial. Then,after you inject the the air into Humulin R (faster-acting insulin) turn the vial upside down to draw 10 units of Humulin R( faster -acting insulin) into the syringe. Once you have drawn up yours 10 units, Insert the needle into the vial of Humulin N (slowe Continue reading >>

Mixing Insulin | Diabetes Forum The Global Diabetes Community

Mixing Insulin | Diabetes Forum The Global Diabetes Community

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Are you mean't to mix Levemir & Humalog in one syringe? I've got fed up with my Insulin Pump, especially in bed, when I can't sleep in the heat and getting tied up in the wire :lol: I've got back to MDI for a bit, have been mixing the two in the morning and at night to save two injections. Also, how long does levemir last? in your body I mean. No you can't mix the two together, mixing the two makes them unstable and may make them less effective, something to do with the pH difference between the two insulin's. The following is potentially going to cause see confusion :roll: :roll: but in a nut shell the jury is still out regarding whether Levemir (Insulin Detemir) and Humalog (Insulin Lispro) can be mixed together and injected. Even health care professionals have been unable to come to an overall consensus on what to advise. If you are treated with Levemir and another insulin/s you should use a separate delivery device for each type of insulin injected. (NovoNordisk 2005) Levemir requires two injections a day but it can be mixed in the same syringe with any of the rapid acting analogues. (Walsh et al Using Insulin 2004 page 105) With regard to the pH - Levemir pH 7.4 Humalog pH 7-7.8 therefore mixing it should make little difference. Always draw up the rapid acting analogue first. Some users have reported problems with the Levemir slowing down the action of whatever it was mixed with. The only insulin that is not advised for mixing with another insulin is Lantus (Insulin Glargine) - pH 4 because of the different pH, and if you mix it with another insulin of a normal ph it will degrade faster. There are several studies on mixing Levemir with Novorapid Continue reading >>

Proper Use

Proper Use

Drug information provided by: Micromedex Make sure you have the type (beef and pork, pork, or human) and the strength of insulin that your doctor ordered for you. You may find that keeping an insulin label with you is helpful when buying insulin supplies. The concentration (strength) of insulin is measured in USP Insulin Units and USP Insulin Human Units and is usually expressed in terms such as U-100 insulin. Insulin doses are measured and injected with specially marked insulin syringes. The appropriate syringe is chosen based on your insulin dose to make measuring the dose easy to read. This helps you measure your dose accurately. These syringes come in three sizes: 3/10 cubic centimeters (cc) measuring up to 30 USP Units of insulin, ½ cc measuring up to 50 USP Units of insulin, and 1 cc measuring up to 100 USP Units of insulin. It is important to follow any instructions from your doctor about the careful selection and rotation of injection sites on your body. There are several important steps that will help you successfully prepare your insulin injection. To draw the insulin up into the syringe correctly, you need to follow these steps: Wash your hands with soap and water. If your insulin contains zinc or isophane (normally cloudy), be sure that it is completely mixed. Mix the insulin by slowly rolling the bottle between your hands or gently tipping the bottle over a few times. Never shake the bottle vigorously (hard). Do not use the insulin if it looks lumpy or grainy, seems unusually thick, sticks to the bottle, or seems to be even a little discolored. Do not use the insulin if it contains crystals or if the bottle looks frosted. Regular insulin (short-acting) should be used only if it is clear and colorless. Remove the colored protective cap on the bottle. Do not Continue reading >>

Insulin (and Other Injected Drugs)

Insulin (and Other Injected Drugs)

Diabetes is a disease affecting the body's production of insulin (type 1) or both the body's use and its production of insulin (type 2). Injectable insulin is a lifesaver for people who can no longer produce it on their own Continue reading >>

Insulin Analogs

Insulin Analogs

Insulin analogs mimic the body’s natural pattern of insulin release. Once absorbed, they act on cells like human insulin, but are absorbed from fatty tissue more predictably. An analog refers to something that is “analogous” or similar to something else. Therefore, “insulin” analogs are analogs that have been designed to mimic the body’s natural pattern of insulin release. These synthetic-made insulins are called analogs of human insulin. However, they have minor structural or amino acid changes that give them special desirable characteristics when injected under the skin. Once absorbed, they act on cells like human insulin, but are absorbed from fatty tissue more predictably. In this section, you will find information about: Rapid-acting injected insulin analog The fastest working insulins are referred to as rapid-acting insulin. They include: These insulin analogs enter the bloodstream within minutes, so it is important to inject them within 5 to 10 minutes of eating. They have a peak action period of 60-120 minutes, and fade completely after about four hours. Higher doses may last slightly longer, but will last no more than five or six hours. Rapid acting insulin analogs are ideal for bolus insulin replacement. They are given at mealtimes and for high blood sugar correction. Rapid-acting insulins are used in insulin pumps, also known as continuous subcutaneous insulin infusion (CSII) devices. When delivered through a CSII pump, the rapid-acting insulins provide the basal insulin replacement, as well as the mealtime and high blood sugar correction insulin replacement. The insulins that work for the longest period of time are referred to as long-acting insulin. They provide relatively constant insulin levels that plateau for many hours after injection. Some Continue reading >>

Mixing Two Kinds Of Insulin In One Syringe

Mixing Two Kinds Of Insulin In One Syringe

Insulin should not be mixed with any other medications unless approved by the prescriber. To prepare insulin from two vials, follow these steps: a. With an insulin syringe and needle, inject air, equal to the dose of insulin to be withdrawn, into the vial of intermediate- or long-acting (cloudy) insulin. Do not touch the tip of the needle to the solution. b. Remove the syringe from the vial of cloudy insulin. c. With the same syringe, inject air, equal to the dose of insulin to be withdrawn, into the vial of rapid- or short-acting insulin (clear) insulin. Then withdraw the correct dose into the syringe. d. Remove the syringe from the clear insulin vial after carefully removing air bubbles in the syringe to ensure correct dose. e. Return to the vial of intermediate- or long-acting (cloudy) insulin and withdraw the correct dose. f. Administer mixture of insulins within 5 minutes of preparing it. Rapid- or short-acting insulin can bind with intermediate- or long-acting insulin, thus reducing the action of the faster-acting insulin. Continue reading >>

How To Mix Insulin Clear To Cloudy

How To Mix Insulin Clear To Cloudy

Learn how to mix insulin clear to cloudy. Drawing up and mixing insulin is a skill that nurses will utilize on the job. Insulin is administered to patients who have diabetes. These type of patients depend on insulin so their body can use glucose. Therefore, nurses must be familiar with how to mix insulin. The goal of this article is to teach you how to mix insulin. Below are a video demonstration and step-by-step instructions on how to do this. How to Mix Insulin Purpose of mixing insulin: To prevent having to give the patient two separate injections (hence better for the patient). Most commonly ordered insulin that are mixed: NPH (intermediate-acting) and Regular insulin (short-acting). Important Points to Keep in Mind: Never mix Insulin Glargine “Lantus” with any other type of insulin. Administer the dose within 5 to 10 minutes after drawing up because the regular insulin binds to the NPH and this decreases its action. Check the patient’s blood sugar and for signs and symptoms of hypoglycemia to ensure they aren’t hypoglycemic …if patient is hypoglycemic hold the dose and notify md for further orders. Key Concept for Mixing Insulin: Draw up CLEAR TO CLOUDY Remember the mnemonic: RN (Regular to Nph) Why? It prevents contaminating the vial of clear insulin with the cloudy insulin because if contaminated it can affect the action of the insulin. Why does this matter because they will be mixed in the syringe? You have 5 to 10 minutes to give the insulin mixed in the syringe before the action of the insulins are affected Demonstration on Drawing Up Clear to Cloudy Insulin Steps on How to Mix Insulin 1. Check the doctor’s order and that you have the correct medication: Doctor’s order says: “10 units of Humulin R and 12 units of Humulin N subcutaneous before b Continue reading >>

Can You Mix Levimir With Humalog In One Syringe ?

Can You Mix Levimir With Humalog In One Syringe ?

Can you Mix Levimir with Humalog in one syringe ? Registration is fast, simple and absolutely free so please,join our community todayto contribute and support the site. This topic is now archived and is closed to further replies. Can you Mix Levimir with Humalog in one syringe ? According to Gary Scheiner " Think Like a Pancreas " (2004 edition) Detimir ( Levemir ) can be mixed with a fast acting insulin. However most other sources state that you can not mix them. Has anyone tried mixing Levemir and Humalog with success ? You can't mix them in the same syringe. What Scheiner means is you can take them at the same time - you just do two injections in different parts of your body. I'd defer to the manufacturers with this, who state explicitly not to mix. AFAIK mixing won't make the world explode but studies suggest it may change the profile of one or both, an x factor you could do without. " Lantus must be given in it's own syring (it can not be mixed with other insulins, meaning that a lot of injections will be necessary. Detemir may be mixed with fast acting insulin." I'm pretty sure that means that Scheiner is saying mixing in the same syringe. ( Not 2 injections in different parts of body) From the Levemir pharmaceutical notes: ( ) If LEVEMIR is mixed with other insulin preparations, the profile of action of one or both individual components may change. Mixing LEVEMIR with insulin aspart, a rapid acting insulin analog, resulted in about 40% reduction in AUC(0-2h) and Cmax for insulin aspart compared to separate injections when the ratio of insulin aspart to Assuming your quote is correct, I don't know why Gary Scheiner recommends this. Potentially mucking around with the onset of insulin is just bad news. The quote form Schiener's book is from 2004. Maybe at the time Continue reading >>

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