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[IP] Re: Mixing insulins

Susan wrote<< 
 When I first came out, I was told and I also read that it should
 not be mixed 
 with other types of insulin, because it would lose it's
 effectiveness >>

Susan - think of insulins as similar but with added "ingredients" to control 
their effect-time.  I think of it as adding "protein" (don't think this is 
really how they make it but the "picture" helps me figure out what I'm doing) 
to prolong the action-time of an insulin.  

Humalog is the most rapid acting and has little or no "protein".  Regular is 
next with some and NPH longest (unless you want to get into the Lente's).  
You can mix insulins in a syringe and their effect will be normal (ie Humalog 
acting shortly, regular taking longer) if they're used immediately.  For 
people will visual problems, I've premixed insulins for their use over a 
week.  Because the insulins blend together in the syringe, their time-effect 
can change (the longer acting affects the shorter making it not work as fast) 
and you need to test to see how the individual responds.  

The trick with mixing insulins is to not allow some of the longer acting 
insulin to get into the shorter acting VIAL because it can alter the 
time-effect of the short (think of it as the long term "contaminating" the 
short acting).  The humalog information sheet states "when you are mixing two 
types of insulin, always draw Humalog into the syringe first.  Always mix the 
insulin preparations in this same sequence (humalog then longer acting 
insulins) in order to maintain purity of the Humalog vial.  

Not sure if this is clear.  The literature can get confusing.  I've read a 
lot of "you shouldn't mix them but added is without a doctor's order" because 
of the varied time-effect.  This can be read by some as "you shouldn't mix 
insulins."  Keeping insulin cold prolongs its life.  I understand you can use 
it for up to a month (in "normal" temperatures) and it will retain its 
potency and effect. 

Let me know if this makes your concern and questions better or worse.  Jill
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