Mixed insulin regimen for adults with type 1 diabetes

Mixed insulin regimens have a minimal role in the treatment of adults with type 1 diabetes. These insulin regimens use a mixture of rapid-acting or short-acting and intermediate-acting insulin given twice daily, most commonly as fixed-dose combination (biphasic premixed or coformulation) insulin. Free-mixed insulin may also be used to allow variation of the ratios of insulin.

If converting from a mixed insulin regimen to a multiple daily injection (basal–bolus) insulin regimen, first calculate the total daily dose of the mixed insulin (sum of all doses of insulin given daily, irrespective of formulation). Give 40% of the total dose as basal insulin. Divide 60% of the total dose equally and give it before meals as bolus insulin (for formulations of basal and bolus insulin, see Action profiles of insulin formulations).