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Insulin is a hormone the body needs to convert sugar, starches and other food into the energy necessary for daily living. There are various insulins and schedules that can be used. It is important that people who take insulin understand how insulin works, what factors affect its action and what schedule will work best for them.
Insulin is Measured in Units
Insulin is Derived in Two Ways
Insulin Action
Know These Facts About Your Insulin
Choosing the Syringe
Drawing Up Insulin: One Type
Mixing Two Types of Insulin
Where to Inject
How to Inject
Insulin: Things to Remember
Insulin Pumps
Insulin is Measured in Units
- There are 10 milliliters (ml) of liquid in each insulin bottle.
- Most insulins are U-100 strength, meaning there are 100 units of insulin in each ml of liquid. So a 10ml bottle of U-100 insulin contains 1,000 units of insulin.
Insulin is Derived in Two Ways
- Bottled "human" insulin is identical to the insulin produced in our bodies, but it does not come from a human pancreas. It is made by a chemical process. Most people use human insulin.
- Animal insulin is obtained from the pancreas glands of pigs.
Know These Facts About Your Insulin
- Brand (or manufacturer)
- Source -- animal or human
- Action -- Rapid, Intermediate, Short or Long
- Strength -- U-100
Important: Be sure to buy the exact insulin prescribed by your doctor.
Insulin Action
The four types of insulin action are noted by a large letter on each bottle.
- Rapid - insulin lispro (HUMALOG) or insulin aspart (NOVOLOG)
- Short - R
- Intermediate - N or L
- Long acting - U or glargine (LANTUS)
| Name |
Letter |
Onset of Action |
Peak Action |
Effective Duration |
| Lispro |
|
15 min |
30-90 min |
3-4 hrs |
| Aspart |
|
15 min |
30-90 min |
3-6 hrs |
| Regular |
R |
30 min |
2-3 hrs |
3-6 hrs |
| NPH |
N |
2-4 hrs |
4-10 hrs |
10-16 hrs |
| Lente |
L |
2-4 hrs |
4-12 hrs |
12-20 hrs |
| Ultralente |
U |
6-12 hrs |
Variable |
18-30 hrs |
| Glargine |
|
3-6 hrs |
None |
24+ hrs |
| 70/30 |
70/30 |
70% NPH and 30% Regular |
| 50/50 |
50/50 |
50% NPH and 50% Regular |
| 75/25 |
75/25 |
75% NPH and 25% Lispro |
No one type is best for everyone. Many different combinations and schedules can be used to provide the insulin needed for a 24-hour period. Choosing the Syringe
Disposable syringes come in various sizes. The most common are:
- 1 cc, which holds up to 100 units
- 1/2 cc, which holds up to 50 units
- 3/10 cc, which holds up to 30 units
- 1/4 cc, which holds up to 25 units
To make it easier to draw up your insulin accurately, use the smallest syringe that will hold your dose.
Be sure the syringes you buy match the concentration of your insulin. If you take U-100 insulin, you need U-100 syringes. Both U-100 insulin and U-100 syringes have orange caps.
Drawing Up Insulin: One Type
Some people use only one type of insulin per dose.* Others require two types of insulin mixed together in one dose. See your health care provider for training in how to draw up and inject insulin correctly.
Drawing Up One Type
1. Gather your equipment: insulin bottle, syringe, and alcohol swab.
2. Wash your hands.
3. For cloudy insulins roll the bottle of insulin between your hands to mix the contents. Thorough mixing is extremely important.
4. Check insulin. Throw bottle out if insulin has clumps.
5. Remove the plastic top from a new bottle.
6. Wipe rubber stopper with alcohol swab.
7. Remove needle cover.
8. Draw air into the syringe until the end of the plunger is in line with the number of units needed.
9. Insert needle through the stopper.
10. Inject air into the insulin bottle through rubber stopper; do not remove syringe. Turn both bottle and syringe upside down keeping needle under the insulin level.
11. Pull plunger down until the end is in line with the number of units needed.
12. Check for air bubbles. If there are bubbles, tap the syringe with your finger to make bubbles float to the top. Inject bubbles into bottle. Pull plunger back again to desired units line. Recheck for bubbles. Repeat above process until all large bubbles are gone.
13. Remove needle from the bottle, ready for injection.
14. If you are not ready to inject, place the needle cover on the needle; lay syringe on a flat surface in a cool spot until ready for injection.
15. If using other than regular insulin, rotate the syringe by hand to remix the insulin before injection.
16. After injection, record your dose, the time given, and the injection site.
Mixing Two Types of Insulin
1. See your health care provider for a demonstration of proper insulin mixing technique.
2. Be sure to check with your health provider to determine what insulins be mixed. Note: Glargine (LANTUS) cannot be drawn into the same syringe any other insulin.
3. For both the clear (rapid and short) and the cloudy (longer-acting) insulins, follow steps 1-7 of “Drawing Up One Type”.
4. Draw air into the syringe equal to the amount of the longer-acting (cloudy) insulin dose. Inject air into the cloudy bottle.
5. Withdraw the needle.
6. Draw air into the syringe equal to the amount of the rapid or short (clear) insulin dose. Inject the air into the clear bottle. Do not remove the needle yet.
7. Turn bottle of clear insulin and syringe upside down. Draw up prescribed number of clear units.
8. Check for bubbles. If there are bubbles, tap the syringe with your finger to make bubbles float to the top. Inject bubbles into bottle. Pull plunger back again to desired units line. Recheck for bubbles. Repeat above process until all large bubbles are gone.
9. Remove needle with clear insulin as prepared.
10. Insert needle into cloudy bottle. Turn bottle and syringe upside down.
11. Draw up cloudy insulin into syringe to the combined dose line. The combined dose line is equal to the number of units of clear plus the number of units of cloudy.
12. Remove needle from cloudy bottle.
13. Give a mixed dose injection soon after preparing.
14. After injection, record your dose, the time given, and the injection site.
 Where to Inject
An insulin injection can be given in any of the body areas shown below. Each area absorbs insulin into the blood at a slightly different rate.
Because the absorption rate varies from area to area, it is recommended that injection sites be rotated within a single area before moving to another area.
Consult Your Health Care Provider For Further Recommendations. How to Inject
1. Choose your injection site.
2. Injection site should be clean and dry.
3. Remove needle cover.
4. Pinch up at least an inch of skin.
5. Insert needle straight into injection site (that is, at a right angle to the site).
6. Push plunger all the way down.
7. Release skin.
8. Remove needle from injection site; do not rub area.
9. Safely dispose of used syringe and needle. Your doctor, pharmacist, or diabetes
educator can show you how.
Insulin: Things to Remember
- Always take your insulin as prescribed. Take extra insulin only if advised by your doctor.
- Give your injections on time and in the same way each time, preferably rotating injections among sites within one body area.
- Record your dose, the time given, and the injection site in your diary.
- Check expiration dates on insulin. The date on the box must allow time for you to use the whole bottle.
- Insulin is stable at room temperature for up to 28 days. It may lose its strength if exposed to cold or heat (less than 32 or greater than 86 F).
- Keep extra bottles, cartridges, or prefilled pens in the refrigerator. Do not freeze.
- Regular (R), lispro (HUMALOG), aspart (NOVOLOG), and glargine (LANTUS) insulins should appear clear. Note: LANTUS, although clear, is not rapid acting
- Other types should be uniformly cloudy (like skim milk) when mixed.
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