Steps for preparing a mixed dose of insulin
Rolling the bottles gently
Step 1. Roll the insulin bottles (vials) gently between your hands. Roll the cloudy insulin bottle until all the white powder has dissolved.
Rolling the bottle warms the insulin if you have been keeping the bottle in the refrigerator.
The order in which you mix the clear (short or rapid-acting) and cloudy (long-acting) insulin is important.
Do not shake an insulin bottle.
Cleaning the lids of the bottles
Step 2. Wipe the rubber lid of both insulin bottles with an alcohol wipe or a cotton ball dipped in alcohol. Let the alcohol dry.
Note: If you are using a bottle for the first time, remove the protective cover from the rubber lid before cleaning.
Drawing air into the syringe for the cloudy insulin dose
Step 3. Remove the plastic cap that covers the needle on your insulin syringe.
Important: Do not touch the needle.
Step 4. Pull the plunger back on your insulin syringe and draw air into the syringe equal to the number of units of cloudy insulin to be given.
Forcing air into the cloudy insulin bottle
Step 5. Push the needle of the syringe into the rubber lid of the cloudy insulin bottle.
Step 6. Push the plunger of the syringe to force the air into the bottle.
This equalizes the pressure in the bottle when you later remove the dose of insulin.
Step 7. Remove the needle from the bottle.
Drawing air into the syringe for the clear insulin dose
Step 8. Pull the plunger of the syringe back and draw air into the syringe equal to the number of units of clear insulin to be given.
Forcing air into the clear insulin bottle
Step 9. Push the needle of the syringe into the rubber lid of the clear insulin bottle.
Step 10. Push the plunger to force the air into the bottle. Leave the needle in place.
Note: You will draw the clear insulin into the syringe first. It is important to follow this order.
Drawing clear insulin into the syringe
Step 11. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.
Step 12. Pull back the plunger to fill the syringe with slightly more than the correct number of units of clear insulin to be given.
Step 13. Tap the barrel of the syringe so that trapped air bubbles move into the needle area. Push the air bubbles back into the bottle.
Important: Make sure that you have the correct number of units of insulin in your syringe.
Step 14. Remove the needle from the clear insulin bottle.
Inserting the needle into the cloudy insulin bottle
Step 15. Insert the needle into the rubber lid of the cloudy insulin bottle.
Important: Do not push the plunger because this would force clear insulin into your cloudy insulin bottle. If clear insulin is mixed in the bottle of cloudy, it will alter the action of your other doses from that bottle.
Drawing cloudy insulin into the syringe
Step 16. Turn the bottle and syringe upside down. Position the tip of the needle so that it is below the surface of insulin in the bottle.
Step 17. Slowly pull back the plunger of the syringe to fill the syringe with the correct number of units of cloudy insulin to be given. This will prevent air bubbles entering the syringe.
Step 18. Remove the needle from the bottle.
You should now have the total number of units for the clear and cloudy insulin in your syringe. For example, if you need 10 units of clear and 15 units of cloudy, you should have 25 units in your syringe.
Now you are ready to give the shot.
Current as of: April 16, 2019
Author: Healthwise Staff
Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Kathleen Romito MD – Family Medicine & David C.W. Lau MD, PhD, FRCPC – Endocrinology & Rhonda O’Brien MS, RD, CDE – Certified Diabetes Educator