My 4 year old grandson has type 1 diabetes. Please advise which of these insulins may be mixed together in the same syringe for his injection, without adversely affecting each other: Humalog, NPH, Ultralente, Regular.

Officially approved by Eli Lilly:

You can mix Humalog with NPH or Ultralente in the same syringe.
You can mix Regular with NPH or Ultralente in the same syringe

Not “officially approved” but published in studies:

Mixing Regular and Humalog together in the same syringe

Officially not recommended

Mixing NPH with Ultralente in the same syringe. According to Eli Lilly the phosphate in the NPH theoretically could precipitate the zinc in the Ultralente. From what I have been told, this is a theoretical concern that has never actually been reported, Humalog by the way also has phosphate and has been extensively studied and approved to mix in the same syringe with Ultralente. I have never been able to get a clear explanation from Eli Lilly why mixing NPH and Ultralente should be a problem but not mixing Humalog and Ultralente.

Here is the mixing guidelines in chart form:

Insulin Mixing Guide

Insulin
Humalog
Regular
NPH
Lente
UltraLente

Humalog
 
Yes*
Yes
Yes
Yes

Regular
Yes*
 
Yes
Yes
Yes

NPH
Yes
Yes
 
No
No

Lente
Yes
Yes
No
 
Yes

UltraLente
Yes
Yes
No
Yes
 

* Not officially approved but published in studies.

I personally have many patients mixing Regular, Humalog, Lente, and Ultralente in the same syringe with no problem. I am aware of many physicians who have their patients mix NPH and Ultralente (with Regular or Humalog ) in the same syringe with no problem.

I suggest that patients or parents ask their own doctor what he or she recommends.

TGL