Accepted answer
Two people working through the same arithmetic independently should get the same answer, and if they do not, someone has made a unit error.
Worked example, because the general form is easier to trust once you have seen it once. Take a 10 mg vial and add 2 mL of diluent: the concentration is 10 ÷ 2 = 5 mg/mL. A 0.5 mg dose is 0.5 ÷ 5 = 0.1 mL. On a U-100 syringe, where 1 unit = 0.01 mL, that is 0.1 ÷ 0.01 = 10 units. Change the diluent to 1 mL and the same dose becomes 5 units — same dose, half the resolution.
The rounding error accumulates if you round too many times — rounding concentration to 5.0, rounding the dose volume to 0.1 mL, rounding the unit reading to 10 — and the safest approach is to work the full precision and round only the final answer.
The insulin-unit standard U-100 means 100 units per millilitre, so one unit is 0.01 mL — this is the conversion that trips up more people here than any other single piece of arithmetic.
The caveat is that this assumes the vial contains what the label says, and if the content assay has not been done, the arithmetic is precise about an unknown quantity.
If in doubt, use more diluent and accept the shorter usable window.
edited 4 Apr 2026 by meniscus_film — added the citation requested in comments
3I have seen exactly this failure mode twice and both times it was the diluent. – esben_lykke 32 days ago 4The distinction between purity and content cannot be repeated often enough here. – k_szabo 3 months ago add a comment