Clinical PEARLS for prescribing insulin

The last couple weeks on the blog we have focused on coming up with an insulin regimen for patients in primary care. Today I wanted to give you some Clinical PEARLS and tips/tricks on prescribing insulin to make your life easier. 

Also, check out my freebie guide to prescribing diabetic supplies here. 

• Insulin concentration (long-acting, regular and rapid acting)- comes in concentration of 100 u/ml. Some can come in 200u/ml or higher but that is reserved for patients taking a really large dose of insulin (likely need endocrinology). 
• Vial size: typically 10ml (so the normal insulin concentration of 100 u/ml, a 10ml vial will have 1,000 units in it)
• When writing prescriptions, add "may change per insurance formulary" on the insulin and/or supplies to save you from a lot of hassle 
• Make sure to add in how many times/day patient should inject insulin or test blood sugars or it will kick back (extra work for you!)
• Sample prescription: 

Lantus 100 units/ml 

Sig: take 10 u nightly 

Disp: one 10ml vial or 1000 units 

• Syringe sizes: 0.3ml can hold up to 30u, 0.5ml can hold up to 50u, and 1.0 ml can hold up to 100u 
• Consider how many units per dose the patient is taking. If they are taking 20u BID, then a 0.3ml syringe is sufficient. 
• Also consider how much insulin they will need. Example, if they are taking 40u daily insulin then they will need 1200u for a 30 day supply (two 10ml vials)
• Don't forget testing supplies (glucometer, test strips, lancets) and/or continuous glucose monitors (ex. Freestyle libra)
• I typically write for BID testing on lancets and strips. Some insurances may cover more (4 times/day) but BID is usually sufficient. 

Come back weekly for new blog posts that can be helpful in practice. I'd love to connect- email me at [email protected] or DM me on social! 

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 Check out all the other blog posts here.