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

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
breakfast daily”

You’re giving a total of 22 units (10 Regular & 12 NPH)

As the nurse, it is important to know the peak times of the insulin you are giving because this is
the most likely time the patient could experience HYPOGLYCEMIA.

Regular insulin has an onset of 30 minutes, peak 2 hours, and duration of 8 hours
NPH insulin has an onset of 2 hours, peak 8 hours, and duration of 16 hours
Learn these insulin mnemonics to remember the onset, peak, and duration times.

2. Wash your hands and don gloves!

3. Roll the “cloudy” insulin vial in between the palms of the hands to mix the ingredients
because if you don’t mix the contents it can alter how much cloudy insulin you are actually
drawing up. DON’T SHAKE the vial because this will cause air bubbles!

4. Clean off tops of vials with alcohol prep for 5 to 10 seconds.

5. Remove cap from syringe.

6. Inject 12 units of air into the Humulin-N vial & then remove syringe from vial.

7. Inject 10 units of air into the Humulin-R vial & turn bottle upside down (while syringe still
inserted into the bottle) and then withdraw 10 units of clear insulin…REMOVE SYRINGE.

8. Insert syringe into Humulin-N and turn bottle upside down and remove TOTAL UNITS
NEEDED by pulling the plunger to 22 units (this will equal removing 12 units of Humulin-N)

9. Recap the needle using the one-hand scoop technique…if not using immediately.