Pre-Mixed Insulin

older couple talking to doctor

Pre-mixed insulin requires only one injection.

Pre-mixed insulin may be right for you if you're older, have vision trouble, or are just starting insulin therapy.

Pre-mixed insulins are usually prescribed for patients needing a simple insulin treatment plan, and sliding scale therapy.

You may be in this category if you:

  • Are older, with regular meal and activity patterns
  • Have diminished vision or trouble with dexterity
  • Are just starting insulin therapy

NPH insulin may be mixed with both rapid-acting insulin analogs and fast-acting human Regular insulin. These mixtures include various combinations:

  • In the United States, rapid-acting insulin, Lyspro (humalog) is mixed with NPH in a 50:50 (50% NPH and 50% insulin Lyspro) and 75:25 (75% NPH and 25% insulin Lyspro) ratio.
  • Insulin/Aspart (Novolog) combinations also are available as 70:30 mixtures (70% NPH, 30% insulin aspart).
  • The traditional NPH ratio of Regular pre-mixed insulin 70:30 (70% NPH, 30% Regular) is still available. These insulins are available as vials, and as insulin pens.

Sliding Scale Insulin Regimens for Type 2 Diabetes - Pre-mixed Regimens

The benefit of pre-mixed insulin is that the fast- and long-acting insulin is combined. No mixing of the insulin is necessary, and there is only one injection.

The disadvantage is that NPH, which has a relatively unpredictable action, is the only long-acting insulin that can be used. Also, when the doses in a mixture is increased or decreased, the amount both of the short acting insulin and long-acting insulin changes, which increases the risk of both high and low blood sugars. Mixtures also don’t allow a separate correction to be made for high blood sugars.

(You may wonder why there are NO pre-mixed insulins using Lantus and detemir. This is because insulin glargine (Lantus®) and detemir (Levemir®) cannot be mixed in the same syringe with other insulins!)

Pre-mixed insulins are usually prescribed for patients needing a simple insulin treatment plan, and sliding scale therapy.

You may be in this category if you:

  • Are older, with regular meal and activity patterns
  • Have diminished vision or trouble with dexterity
  • Are just starting insulin therapy

Self-assessment Quiz

Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Insulin Therapy, take our self assessment quiz when you have completed this section.  The quiz is multiple choice. Please choose the single best answer to each question. At the end of the quiz, your score will display. If your score is over 70% correct, you are doing very well. If your score is less than 70%, you can return to this section and review the information.

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