Understanding R, N, and Premixed Insulins

Sometimes due to choice, cost, insurance coverage you may find yourself on N, R, or pre-mixed insulin.

The following is some information to understand what the types are, how they are taken, and who might be taking them.

What is R insulin and when should I take it?

Regular or R insulin is clear in color, considered short acting, and is available in names including: Humulin R, Novolin R, ReliOn R. This insulin starts working in 30 minutes and lasts for about 5-8 hours. Regular insulin is taken 30 minutes before meals. It helps to provide coverage for your meals. If you use in combination with N insulin, you would take it before breakfast and dinner. If skipping a meal, you would skip your R insulin.

How much is R insulin?

R insulin is considerably cheaper than rapid acting analogs such as Humalog or Novolog. Check with your pharmacy for exact pricing.

What is N insulin and when should I take it?

NPH (N) is a cloudy colored, intermediate acting insulin, and is available as Humulin N, Novolin N, ReliOn N. It starts working in about 1-3 hours, and can last for approximately 10-18 hours. N insulin helps to cover in between your meals and the N you take at breakfast will still be working at lunch to cover your meal. It is essential that you have lunch every day, about 4-5 hours after you inject your N at breakfast. If you do not have lunch, you will be at risk for going too low. The N you take at bed will work during the night to help regular your morning glucose levels. You should have a small bed time snack.

NPH or N insulin would be taken with breakfast and before bed for better fasting glucose levels, however instead of giving it at bed, it may be given before dinner also.

How much is N insulin?

N insulin is a cheaper alternative to longer acting insulins. Check with your pharmacy for pricing.

If I’m taking both N and R insulin can I mix them in the same syringe?

Yes, N and R can be mixed in the same syringe, draw R (clear) first and then N (cloudy).

What is pre-mixed insulin and when should I take it?

Pre-mixed insulin is a cloudy-colored, combination of intermediate acting insulin and short acting insulin, and it is available in the names Humulin 70/30, Novolin 70/30, and ReliOn 70/30. It is 70% intermediate acting insulin (N) and 30% short acting insulin (R).

When should I take my pre-mixed insulin?

Pre-mixed insulin should be taken 30 minutes before breakfast and dinner. The dose you take at breakfast is still working at lunch time and it is very important that you always eat lunch, or you will be at risk for going too low.

How is Humulin 70/30, Novolin 70/30, ReliOn 70/30 available?

Humulin 70/30 is available in pen and vial , Novolin 70/30 and ReliOn 70/30 are available in vial.

How much is pre-mixed insulin?

Pre-mixed insulin can be cheaper than other types of insulin, so inquire with your pharmacy.

Remember no matter what insulin regimen you are prescribed, nothing will work if you are not compliant with your medications. Taking your insulin as prescribed and checking your blood glucose throughout the day will help you gain better control of your diabetes. Always bring your glucose logs to your healthcare provider appointments.