Individuals with diabetes are more actively responsible for the management of their disease than people with many other types of illness. This is both a burden and an opportunity to gain a sense of control over your own health. In addition to monitoring your diet, checking your blood sugar, getting regular exercise and self-administering medication, you may be asked to mix different types of insulin.
Insulin's Effect on Blood Glucose
Normally, the body uses insulin from the pancreas to keep the blood glucose at a normal level. This hormone is released into the bloodstream when food is eaten and it signals the cells in the muscles and liver to gather some of the glucose from the blood, keeping it at a stable level. When this system fails to work properly, an insulin product must be used. Most people with insulin-dependent diabetes use insulin that is injected into the fat layer on a daily or more frequent basis.
Types of Insulin
Regular insulin is a clear, short-acting insulin. It is typically given just prior to meals or after a blood glucose check has revealed an elevated blood glucose. Regular insulin is often used for sliding scale insulin, meaning the physician has ordered a range of doses depending on the current blood glucose reading. Longer-acting insulins are often taken once per day. They peak later and have a much longer period of duration. Pre-mixed insulins contain both short-acting insulin and longer-acting insulin and are typically given one or more times per day. Occasionally, they are given per sliding scale as well.
Mixing Insulin Types
Diabetics are often ordered to take two different kinds of insulin -- short-acting regular insulin and a longer-acting insulin -- at the same time. The mixing procedure involves putting the two different insulin types into one syringe by drawing up the clear, short-acting insulin first. You should mix insulin only if your physician has stated that it is safe to do so and a physician, nurse or pharmacist has monitored your mixing technique and given approval.
Benefits and Risks to Mixing Insulin
Insulins are often mixed at home to save on supplies and unnecessary needle sticks. Multiple needle sticks are painful and they slightly increase the risk of scarring or infection at the injection site. The mixing procedure is not without risk, however. You must be sure that you draw up the correct amount of each insulin, because a higher than desired dose of regular insulin can cause significant hypoglycemia, or low blood sugar. You must also avoid mixing certain insulin types, such as NPH insulin and Lente or Ultralente insulin, explains the National Federation of the Blind. Your pharmacist is an excellent resource for insulin-mixing information if your physician is unavailable for guidance.
References
- UPMC; Insulin: How to Give a Mixed Dose; 2008
- BD Consumer Healthcare; My Doctor Says I Need to Mix Insulins; 2007
- National Federation of the Blind: Insulin Types: A Review
- National Diabetes Information Clearinghouse: Types of Insulin
- "Nurses' Guide to Clinical Procedures, Fourth Edition"; Jean Smith-Temple, M.S.N., R.N., et al.; 2002
