Covering All the Bases When Prescribing Insulin

Covering All the Bases When Prescribing Insulin

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Jay H. Shubrook, DO: Whats up. This is Jay Shubrook, DO, family doctor and diabetologist at Touro University in California. In this continuation of our collection on practical use of insulin in main care, I’m completely happy to welcome my colleague, Kim Pfotenhauer, DO, assistant professor within the Main Care Department at Touro University, California. Thanks for joining us at this time.

Kim M. Pfotenhauer, DO: Howdy, Jay. Thank you for having me.

Dr Shubrook: Writing a prescription for insulin is, in many ways, much more durable than writing a prescription for a pill or a capsule. In truth, pharmacists inform us all the time that insulin prescriptions are some of the widespread prescriptions sent back due to errors in how they’re written, together with being written incompletely.

I want to speak a bit bit about greatest practices in prescription writing for insulin. When you’re writing a prescription for insulin, how do you begin? What do you contemplate?

Dr Pfotenhauer: One of many first things that you must think about after choosing an insulin is what the dose of the insulin goes to be.[1] You need to take into consideration a number of issues. It’s a must to take into consideration the focus of the insulin that you’re utilizing and whether it’s dosed in a pen or a vial. As an example, if a patient is taking 10 U in the night, we all know that pens include 100 U/mL, and there are 3 mL in every pen. If your affected person is utilizing 10 U in the evening, the monthly dose is calculated at about 300 U, which would be 1 pen for the month. Equally, for vials, we might do the identical thing, however vials have 10 mL as an alternative of 3 mL; we need to calculate that dose both by 1 month or by three months. Just getting used to and getting extra snug with doing that math is actually essential as physicians.

Dr Shubrook: So first you decide an insulin, then you definitely decide a pen or vial, and then you definitely decide the dose to understand how much you will want. What different issues must be thought-about for that prescription?

Dr Pfotenhauer: It is advisable to embrace a number of things, including the focus of the insulin, the dose the patient goes to take, and the way the affected person is going to take it—for instance, inject subcutaneously. Additionally it is necessary to include the analysis on the script for insurance functions.

Dr Shubrook: Really good level. The insurance company will need to know why the individual is taking it. How concerning the time of the day; do you embrace that in your prescription?

Dr Pfotenhauer: Absolutely. Most long-acting insulin is dosed in the evening, however it can be dosed in the morning. You need to embrace that it is dosed just once a day.

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