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September 2, 1999

Insulin

Question from St. Charles, Missouri, USA:

My son is 7 years old and was diagnosed with Type 1 about 2 1/2 years ago. He will be visiting his grandparents in another state soon. He takes two injections per day, one in the morning and one at dinner. In these two injections he uses Humalog and NPH. The dosage for the NPH is constant (11.5 units in the A.M.; 5 units in the P.M.); the amount of Humalog will vary depending on his blood sugar at the time. In order to make this a little easier for his grandparents, I am wondering it I can go ahead and load the syringes with the proper amount of NPH ahead of time. Then, all they would have to worry about measuring and adding is the Humalog. Will the NPH insulin keep for a week if it is pre-loaded in the syringes? Will it matter if the Humalog is added after the NPH is already in the syringe?

Answer:

In general we don’t recommend pre-filling syringes. I would talk to your child’s diabetes care provider for the answer on what you should do, and follow their instructions.

If you pre-fill the syringe, you may lose some of the fast acting insulin and get a little more long acting (NPH) insulin. This is usually not a big problem, however. If you do pre-fill the syringes, lay them flat in the refrigerator, and make sure the insulin in the syringe is mixed before injection (gently tip syringe back and forth)

Is there a visiting nurse organization that could help?

LM