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Mixing Insulin • Diabetes Center • PreOp® Patient Education HDhttp://www.PreOp.com

Your doctor or diabetes educator may ask you to mix a short-acting or clear insulin
with an intermediate or long acting cloudy insulin in the same syringe so that both can be given at the same time.
The only insulin that cannot be mixed is insulin glargine.
In this example, the doctor has asked you to mix 10 units of regular, clear, insulin with 15 units of NPH cloudy insulin, to a total combined dose of 25 units.
Always, draw "clear before cloudy" insulin into the syringe. This is to prevent cloudy insulin from entering the clear insulin bottle.
Always do this procedure in the correct order, as shown in the following sequence.

Roll the bottle of the cloudy insulin between your hands to mix it.
Clean both bottle tops with an alcohol wipe.
Pull back the plunger of the syringe to the dose of the long-acting (cloudy) insulin in this example 15 units. You now have 15 units of air in the syringe.

Check the insulin bottle to ensure you have the correct cloudy type of insulin.

With the insulin bottle held firmly on a counter or tabletop, insert the needle through the rubber cap into the bottle.
Push the plunger down so that the air goes from the syringe into the bottle. Remove the needle and syringe. This primes the bottle for when you withdraw the insulin later.
Pull back the plunger of the syringe to the dose of the shorter acting clear insulin in this example 10 units. You now have 10 units of air in the syringe.
Check the insulin bottle to ensure you have the correct clear type of insulin.

With the insulin bottle held firmly on a counter or tabletop, insert the needle through the rubber cap into the bottle.
Push the plunger down so that the air goes from the syringe into the bottle.

Turn the bottle upside down so that the air in it goes to the top.
With the tip of the needle kept in the liquid, withdraw the dose of clear insulin, in this example, 10 units.

Remove the needle and syringe.

Go back to the longer-acting, cloudy insulin bottle.

Turn it upside down. Insert the needle into the liquid and slowly pull back the plunger to measure your total dose, in this example, 25 units. You are now ready to give your injection.