Hi, my Dad has forgotten to roll and invert my Mum's mixed insulin properly, does anybody know what this is likely to do? I guess either a shortfall of long or short acting will have been injected and it is important to watch for hypos for a few hours? Anybody know? It is humalog 25/75.
Ali
Hey there. I'm not an expert in mixed insulins, but I used to take intermediate insulin which was cloudy and needed mixing. The clear liquid was effectively the insulin while the cloudy bit was the particles and suspension that slowed down the absorption of the insulin in the body. When I forgot to mix it, the insulin acted more quickly and didn't last as long, so I went a little low fairly quickly and then a bit high when the insulin had worn off.
Applying this to your mum's mixed insulin, I would say that she might get the full effects of both the 25% bolus and 75% basal at roughly the same time because the particles are heavier than the clear liquid, so without mixing it, she will have got a dose of the clear liquid i.e. long and short acting insulin but none or very little of the particles to slow down the absorption of the long acting. So, I would expect you might see her drop a bit low in the next couple of hours, followed by being higher than usual later on when the insulin has worn off.
All you can do is keep an eye on it and correct as appropriate.
Smidge