How to prepare mixed-dose insulin with a syringe

Taking more than one type of insulin in a single injection is called a “mixed dose” of insulin. A mixed dose gives you the benefits of both short-acting and longer-acting insulin without having to give yourself 2 separate shots.

Mixed doses of insulin are usually taken 1 or 2 times a day. To get started, you’ll need:

• An insulin syringe
• Insulin (at room temperature)
• An alcohol swab

To prepare your mixed-dose insulin injections, follow these steps:

1. Wash your hands with soap and water.
   • Note: If using cloudy insulin (NPH, 70/30, 75/25, 50/50), roll the bottle between your hands just enough to stir up the contents.
     
     
2. Clean the rubber stopper of the NPH (cloudy) insulin bottle with alcohol. Let it dry.
   
   
3. Remove the plastic cap covering the needle on the syringe.
   • Do NOT touch the needle.
     
     
4. Pull the plunger out far enough to fill the syringe with air equal to the number of units of NPH (cloudy) insulin you need.
   
   
5. Insert the needle into the NPH (cloudy) insulin bottle and push the plunger in. This will force the air from the syringe into the bottle.
   Do NOT draw any NPH (cloudy) insulin into the syringe. Just pull the needle out of the bottle.
   • Note: At this point, the syringe is still empty.
     
     
6. In the same way you just did, now fill the syringe with air equal to the number of units of fast-acting (clear) insulin you need.
   
   
7.  Insert the needle into the bottle of fast-acting (clear) insulin and push the plunger in. This will force the air from the syringe into the bottle.
   • Do NOT take the needle out of the bottle.
     
     
8. With the syringe needle still in the fast-acting (clear) insulin bottle, turn the bottle and syringe upside down.
   • Pull the plunger out to draw your dose of fast-acting (clear) insulin into the syringe.
   • If you see any air bubbles in the syringe, gently flick it with your finger to help the air bubbles rise.
   • When the syringe is free of bubbles, pull the needle out of the fast-acting (clear) insulin bottle.
   • Note: At this point, the syringe now holds your dose of fast-acting (clear) insulin.
     
     
9. Now insert the needle back into the NPH (cloudy) insulin bottle and turn the bottle and syringe upside down.
   • Do NOT push the plunger in.
   • Instead, pull the plunger out to draw your dose of NPH (cloudy) insulin into the syringe.
   • Note: Give the injection within 5 minutes of mixing. See How to prepare and take an insulin injection  for details on giving yourself the shot.