When it comes to managing diabetes, properly mixing insulin is very important for achieving the best results. Insulin is a hormone produced by pancreas and its primary role is to regulate blood sugar levels in the body. For people with diabetes the body does not produce enough insulin (type 1diabetes) or does not use insulin effectively (type 2 diabetes). Mixing insulin is important for those using more than one type of insulin to manage their diabetes. They use both cloudy (NPH) and clear (regular insulin) types. It needs to be combined in a specific way also known as “clear to cloudy” to ensure accurate dosing.
Types of insulin
There are two types of insulin known as clear and cloudy insulin.
Clear insulin:
Rapid acting or regular insulin is designed to quickly lower blood sugar after meals.
- It is transparent and clear therefore known as clear insulin.
- It is used first in mixing process.
Example: Insulin aspart, Insulin lispro and Regular insulin.
Cloudy insulin:
- It takes longer to begin working.
- It is cloudy because it has particles that settle at the bottom of vial or pen therefore it should be mixed before using to ensure proper dosage.
- It is used second in the mixing process.
Example: NPH insulin
Clear to cloudy: Mixing two insulins
When combining clear and cloudy insulin this method “clear to cloudy” is used. This means that combining two insulins in one syringe it is important to draw the clear insulin first and cloudy insulin second.
Reasons:
- To avoid contamination of clear insulin.
- Preserve the integrity of both insulins.
- Ensuring proper dosage.
- Helps maintain effectiveness and purity of both clear and cloudy insulins.
Step by step guide on how to mix Insulins
Properly mixing two insulins is really important for proper dosage. Here is step by step guide on how to mix both insulins (clear to cloudy).
Gather your supplies:
- First it is important to gather your supplies that you will be needing such as:
- Insulin vials (both clear and cloudy).
- Alcohol wipes to disinfect the area.
- Syringe or insulin pen.
Wash your hands:
Wash your hands thoroughly before handling insulin to avoid contamination. Use 20 second rule to wash your hands.
Inspect your insulin vials:
- Check the expiration dates on both insulins before using.
- Clear insulin should be free from any particles and discoloration.
- Gently roll the cloudy insulin in your hand and do not shake it. Gently rolling will help mix the particles evenly before using. Avoid shaking as it might cause air bubbles.
How to draw and mix insulin:
- Clean the top of the vials with alcohol swabs and remove the caps.
- Draw air into the syringe by pulling the syringe plunger to the amount of insulin you need.
- Inject the air into the cloudy insulin first to prevent the vacuum from forming inside the vial.
- Next move to clear insulin vial and draw the correct amount of clear insulin. Tap the syringe to make sure there are no air bubbles and gently push the air out.
- After clear insulin, insert the needle into cloudy insulin vial and draw the amount needed. Since you already injected the air in this vial, this will help not to contaminate the clear insulin with cloudy insulin.
- Double check the amount of insulin before administering it.
- Inject the insulin according to healthcare providers instructions.
- Use new sire for injecting the syringe or insulin pen to avoid any skin issues.
Tips for safe mixing of the insulin
Here are safe tips on how to mix NPH insulin with regular insulin. That means mixing clear insulin with cloudy insulin to get proper dosage.
- Do not shake the cloudy vial as it can cause air bubbles. Just roll in gently to mix the particles evenly.
- Mix in the correct order which is from clear to cloudy. This means take clear insulin first and then mix it with cloudy insulin.
- Always keep insulin at the right temperature to maintain its effectiveness.
- Always follow the guidelines provided by your healthcare worker before mixing and administering the insulin.
- Clear insulin is always rapid acting.
- Cloudy insulin such as NPH is intermediate acting.
- Check the expiration dates on both vials before using.
- Never shake the cloudy insulin instead roll it gently in your hands to mix the particles.
Which insulin should never be mixed?
Long-acting insulins should never be mixed such as Lantus, Levemir, Toujeo and Tresiba.
How long do you have to wait between shots of insulin?
If you are taking your insulin dosage twice a day, then take it between 8 to 12 hours apart.
Why do you roll cloudy insulin and not shake it?
Before using cloudy insulin, you have to gently roll it to mix the particles evenly. Never shake the cloudy insulin as it can cause air bubbles.
Where should you not inject insulin?
The places where you should not inject insulin are muscles, near bones, veins, face, or scalp, naval, hands or feet, bruised area, around scars or moles.
Where can you inject the insulin for safer use?
The insulin should be injected into the abdomen, thigh, and arm.
Conclusion
Properly mixing insulin is important step to managing diabetes effectively. The correct process that is used for mixing two types of diabetes in from “clear to cloudy.” There are two types of insulins, clear and cloudy insulin. Clear insulin is transparent and should be drawn first in the syringe. The cloudy insulin has small particles and is drawn after the clear insulin. Do not shake the cloudy insulin to prevent air bubbles instead roll in gently to mix the particles. In this blog we have provided you step by step guide on how to mix insulin.
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