Total Daily Insulin Requirement:
= 500 ÷ TDI = 1unit insulin/ 12 g CHO
This example above assumes that you have a constant response to insulin throughout the day. In reality, individual insulin sensitivity varies. Someone who is resistant in the morning, but sensitive at mid-day, will need to adjust the insulin-to-carbohydrate ratio at different meal times. In such a case, the background insulin dose would still be approximately 20 units however, the breakfast insulin-to-carbohydrate ratio might be breakfast 1:8 grams, lunch 1:15 grams and dinner 1:12 grams.
The insulin to carbohydrate ratio may vary during the day.
Prescribing Insulin In Enterprise Rx For Practice Partner 112 Users
Topics:Practice Partnermedisoft clinicalLytec MD
Important prescribing information for users of Practice Partner, Medisoft Clinical and Lytec MD.
Under the new Scripts2017 regulations from NCPDP Vial and Pen are no longer available units during the prescribing process.
The upgrade to the newest version 11.2* of Practice Partner,Medisoft Clinical or Lytec MD EHR provides a significantly improved prescribing process giving providers new tools to allow them to quickly and easily prescribe and manage patient medications and pharmacies.
However to comply with the new regulations there are some changes to existing workflows and processes that providers need to be aware of.
One of those changes is how Insulin is now prescribed for user of the 11.2 version.
The steps below outline the new process to prescribe Insulin in v11.2
Writing the insulin prescriptions:
The medication needs to be prescribed in Milliliters . The pharmacist will convert the milliliters ordered to the appropriate number of vials or pens based on the drug name entered.
Calculate the number of milliliters:
Take the total max daily dose and multiply by the number of days supply to be prescribed.
Divide the total by the number of units per ml
Round the result to the next whole number
Example of prescribing by vial: HumaLOG U-100 Insulin, max daily dose 50 units daily, with a 90 day supply.
- Review the package size: HumaLOG U-100 Insulin 100 unit/mL subcutaneous Vial – VIAL 10 ml
Rationale Of The Week
Our March 23rd Question caused a lot of commotion. Less than half of respondents chose the best answer, so we wanted to dive deeper into this question of how many pens are needed.
Before we start though, if you dont want any spoilers and havent tried the question yet, you can answer below: Answer Question
Question: JR is 24 years old and uses an insulin pen for their basal insulin injections each evening. JR takes 30 units a night and each insulin pen holds 300 units of insulin.
How many insulin pens would JR need for one month?
As shown above, the most common choice was option 2, the second most common answer was option 1, then option 4, and finally option 3.
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How Many Doses In A Lantus Pen And How Long Will It Last Me
The Lantus SoloStar is 100Units/mL and is a 3ml unit, so each Lantus Solostar contains 300 units.
To work out how long one Lantus SoloStar pen will last you, you need to divide 300 units by your daily dose. For example:
- If you are using 12 units a day
- 300÷12= 25 days
- The Lantus SoloStar will last you 25 days.
If you are priming your pen before each dose, which is recommended, you do need to add this into your calculation. For example:
- If you are using 13 units a day
- Plus 2 units for priming = 15 units per day
- 300÷15= 20 days
- The Lantus SoloStar will last you 20 days.
How Long Does Lantus 10ml Multiple Dose Vial Last Once I Have Started Using It
The Lantus 10mL multiple dose vials expiry, once you have started using it, is 28 days. If you are on a low dose then one Lantus 10mL multiple dose vial may contain more than 28 days worth of insulin. In this case it is important to remember to discard the remaining Lantus 10mL multiple dose vial 28 days after you have started using it, even if it still contains insulin.
Once you have started using Lantus 10ml multiple dose vial it can be kept at room temperature or in the refrigerator.
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How Many Insulin Vials
To quickly calculate the number of vials necessary for a 90-day supply of insulin, take the total daily dose and divide by 10. For example, if a patient is taking isophane insulin 30 units b.i.d., the TDD is 60 units per day 60 divided by 10 is six. Therefore, six vials are needed to cover the patients basal needs for the 90-day period. Remember, opened insulin vials should be thrown out after 28 days.LEE ERBE, NP-BC, and JEREMY SOULE, MD, Charleston, S.C.
How To Pick An Insulin Pen With Your Doctors Help
So, which option is best for you? Isaacs suggests asking your healthcare team the following questions to determine the best fit:
- What are my insulin delivery options?
- What options will insurance cover?
- Would I benefit from having a dosing calculator to help calculate insulin doses?
- Would I benefit from a pen that helps keep track of all insulin doses?
- Would I benefit from a pen that knows when a previous insulin dose is still working in my system?
Insurance coverage will likely drive your choice, says Bzowyckyj. If you have multiple options, consider dexterity , whether youll need to administer partial doses, and whether you prefer a disposable pen or a reusable pen that has disposable cartridges, he says. Not everyone prefers to use an insulin pen, but those who do find it easier and much more convenient to use than the traditional vial and syringe, he says.
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How To Dispose Of Insulin Vials
Empty, old, or expired vials of insulin must be disposed of immediately so there’s no possible confusion with the good ones. The disposal of insulin vials, pens, and cartridges may vary according to local laws.
Sometimes, its fine to throw your vials in the household trash. They do not recycle. In that case, make sure to empty them first.
You may also be required to dispose of your insulin vials through a drug collection program or to place them in certain containers. Ask your pharmacist.
Used needles and syringes must be disposed of in sharps containers!
How Much Insulin To Take For Bodybuilding
Injecting insulin is not a safe approach to weight training. However, some bodybuilders will inject it as a performance-enhancing drug. They believe injecting insulin will allow energy in the form of glucose to enter their cells so they can build more muscle.
This practice is unsafe and can lead to severe and potentially life threatening hypoglycemia, according to 2019 research.
You should not take insulin unless you have diabetes. If you do have diabetes, talk with your doctor about how your training regimen may affect your blood sugar levels.
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How Many Vials Of Insulin Do You Need Per Month
How many vials of insulin you need per month really depends on the treatment plan decided with your doctor. Diabetes is a disease that affects each person differently. Insulin dosage is highly variable from one person to the other.
While some diabetics are fine with 10 units of long-acting basal insulin, others need 50 units plus 60 units or more of fast-acting bolus insulin per meal! However, to give you an idea, most diabetic patients use two to three vials of insulin per month.
Example #: Carbohydrate Coverage At A Meal
First, you have to calculate the carbohydrate coverage insulin dose using this formula:
CHO insulin dose = Total grams of CHO in the meal ÷ grams of CHO disposed by 1 unit of insulin .
For Example #1, assume:
- You are going to eat 60 grams of carbohydrate for lunch
- Your Insulin: CHO ratio is 1:10
To get the CHO insulin dose, plug the numbers into the formula:
CHO insulin dose =
- The carbohydrate coverage dose is 6 units of rapid acting insulin.
- The high blood sugar correction dose is 2 units of rapid acting insulin.
Now, add the two doses together to calculate your total meal dose.
Carbohydrate coverage dose + high sugar correction dose = 8 units total meal dose!
The total lunch insulin dose is 8 units of rapid acting insulin.
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How Much Insulin Is Too Much To Take For High Blood Sugar
Ideally, you should be able to correct your blood sugar with an appropriate insulin dose. How much insulin is too much varies based on how sensitive your body is to insulin.
If you have higher-than-expected blood sugar , you should check your urine for ketones. The presence of ketones suggests your bodys cells are having trouble getting enough glucose. You could be at risk for a serious condition called diabetic ketoacidosis if you have ketones in your urine.
In this instance, you need extra help correcting your blood sugar. You should seek emergency medical attention instead of trying to keep injecting insulin to lower your blood sugar.
How To Use Insulin Pens
Always follow the instructions of the pen youre using. But to give you an idea, below are general steps of using a disposable insulin pen .
Abdomen injection site
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How Insulin Injection Methods Compare
Insulin injections are taken by people with diabetes whose bodies dont make insulin, dont make enough of it, or dont respond effectively to the insulin they are making, according to MedlinePlus. They are typically self-administered, up to several times a day, using a needle, syringe, and vial a pen or a computerized pump with a tube that is inserted by needle under the skin of the abdomen and kept in place with tape, notes the Cleveland Clinic. On average, people with type 1 diabetes each injected 62 units of insulin daily in 2016 and spent $5,705 annually on insulin, according to the Health Care Cost Institute .
For many people, the least-expensive way to take insulin is using a needle, syringe, and vial, because these supplies are most likely to be covered under Medicare, state Medicaid plans, and private insurance than other injection methods, according to a study published in April 2018 in European Endocrinology. But syringe delivery is also the most painful and difficult method, with a higher risk of dosing errors and hypoglycemia episodes than other methods.
People who use pumps have insulin delivered to them 24 hours a day in a manner that mimics the bodys own way of releasing insulin. Yet pump delivery can be expensive costing as much as $4,500 for the device without insurance, an additional $1,500 per year in supplies, according to an article published in June 2017 in the American Journal of Managed Care.
How Much Does A Vial Of Insulin Cost
In the United States, the price of a vial of insulin is around $200 without health insurance According to a 2018 report, you can find over-the-counter insulins sold at Walmart for as little as $25 per vial, while the newest insulins cost between $175 and $300 per vial.
Using human insulin sold at Walmart may have serious consequences on your blood sugar levels and diabetes management. These insulins do not work the same way as analog insulins do. They may have different times of action, peak times, as well as reduced effectiveness. Always ask for your doctors advice before using a different brand of insulin than the one youve been prescribed.
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Insulin is a very expensive medicine. Keep your vials safe, and protect them from shattering and bacterial contamination. Use a silicon insulin vial protector like the ones from 4AllFamily. These little things can make you save hundreds of dollars worth of medicine!
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How Long Does Lantus Solostar Last Once I Have Started Using It
The Lantus SoloStar pens expiry, once you have started using it, is 28 days. If you are on a low dose then one Lantus SoloStar pen may contain more than 28 days worth of insulin. In this case it is important to remember to discard the remaining Lantus SoloStar pen 28 days after you have started using it, even if it still contains insulin.
Once you have started using Lantus SoloStar it should be kept at room temperature and NOT in the refrigerator.
Example #: Formulas Commonly Used To Create Insulin Dose Recommendations
This example illustrates a method for calculating of your background/basal and bolus doses and estimated daily insulin dose when you need full insulin replacement. Bear in mind, this may be too much insulin if you are newly diagnosed or still making a lot of insulin on your own. And it may be too little if you are very resistant to the action of insulin. Talk to your provider about the best insulin dose for you as this is a general formula and may not meet your individual needs.
The initial calculation of the basal/background and bolus doses requires estimating your total daily insulin dose:
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Insulin: A 2014 Primer Part 2 Insulin Delivery And Insulin Pumps
In Part 1, the authors reviewed the clinical aspects of insulin dosing and titration for primary care physicians. In this section, the authors review new and emerging insulin products, the practical aspects of writing insulin prescriptions, delivery of insulin, and advanced insulin delivery systems .
How To Calculate An Insulin Dose
Before using the dose calculator, make sure your therapy settings are correct and that all of your recent doses are logged.
Open the InPen app.
Tap the orange dose calculator icon on the home screen.
Enter your current blood glucose and/or the number of grams of carbs you are eating or plan to eat. If you have already connected your glucose meter to the InPen app, your current blood glucose will automatically appear in the blood glucose cell.
View the Recommendation or Warning at the top of the screen and act accordingly.
If you see Units of Insulin, this is the recommended number of units of insulin to take now.
If you see Grams of Carbs, eat that many grams of carbohydrates now to avoid low blood glucose in the near future.
If you see 0 Units, no additional food or insulin is recommended at this time.
The Eat fast acting carbohydrates to treat your low blood glucose recommendation will be shown if you entered a very low blood glucose value, regardless of active insulin or carbs entered. If your blood glucose is low, it is important that you eat fast-acting carbohydrates. If you believe the message is in error, then check the blood glucose value you entered.
The Monitor Glucose Warning will be shown if your glucose may drop low due to your active insulin. Check your glucose frequently over the next few hours.
When you are done using the calculator, tap Save to automatically save your entries to the Logbook.
Additional information about the dose calculator:
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How Do I Calculate How Much Insulin To Take
In people who do not have diabetes, their bodies release insulin in response to the foods they eat. This is because many foods contain carbohydrates. Some examples include bread, sweets, fruits, and even vegetables.
Your body breaks carbohydrates down into smaller building blocks, like glucose. You need insulin to use this glucose for energy. If your body cannot make or use insulin effectively, youll need to inject it to process your food for energy.
Calculating how much insulin to take is usually based on two considerations:
- Basal insulin dose. A basal insulin dose is an amount that you give yourself daily regardless of the foods you eat.
- Bolus insulin dose. A bolus insulin dose helps correct or anticipate the carbohydrates you eat throughout the day. You will usually correct this with a bolus dose of rapid-acting insulin.
Anticipating a bolus dose is where insulin administration can get tricky. When you give yourself insulin, you are estimating how many units of insulin it will take to process the carbohydrates you eat.
The University of California, San Francisco states that, as a general rule, 1 unit of insulin will process anywhere from 12 to 15 grams of carbohydrates and lower your blood sugar by about 50 milligrams per deciliter .
Since the human body is so complex, not all people will process insulin the same way. Factors like time of day, stress levels, and physical activity can make these numbers more difficult to predict.
How Much Insulin To Take Per Carb
The average person will take about 1 unit of insulin for every 12 to 15 grams of carbohydrates consumed.
There is some variation to this, depending on how sensitive you are to insulin. For some people, this range is 1 unit for every 6 grams of carbohydrates, while for others, its 1 unit for every 30 grams of carbohydrates.
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