SARAH: Thank you so much for joining us again today on the Qi Hub video series. We are joined again by our favorite, most favorite clinical pharmacist, Dr. Sarah Atkins. So thank you so much for being here. Dr. Atkins. Sarah, 

DR. ADKINS: oh, it is so, so, so good to be back on this side of the table. So good. Yeah, don't get used to it.

SARAH: So what we're gonna talk about today is insulin. So we have been doing a video series on medications for type two diabetes according to the ADA standards of care section 9 pharmacologic approach, and one small more. The small piece of information we'd like to add is about insulin. So, um, Sarah, what would you like to share with us about insulin today? 

DR. ADKINS: Okay, so let's talk just a little bit about insulin, right? So we also, were gonna focus back on those a DA standards of care, just like you had mentioned Section nine, pharmacologic approach. Fantastic. I don't wanna mention a whole lot about insulin. I think we know a lot about it, but I wanted to say this about it, that remembering that there are different formulations of insulin that are out there. I think this is pretty common. And also I'm gonna talk about, similar to the GLPs right, about what is on formulary. And so insulin can have that same issue, right? There can be different insulins that are on formulary, which makes it hard sometimes. Um, again, with Medicaid usually there's a lot more space with that, um, to have excellent coverage. So, but if there's not, it's just important to know which product is is covered. Um, I also wanna add that Basaglar is the same thing as Lantus and Rising Suns has the Basaglar. And I also wanted to talk about, um, brands and generics of that. So like Lantus is technically a brand name for insulin glargine, right? So insulin glargine is the actual chemical name if you didn't know that. Just saying. So insulin glargine. So Basaglar is also insulin glargine. It's actually not technically called a generic drug. It's called a biosimilar, Sarah, did you know that? So anyway, medications that aren't actual drugs, like chemical drugs, they're considered a biosimilar because they're made with biologic material very different than just a drug brand and generic. So I think that in the future we'll be seeing more of these come out for other biologics and not just the insulin products. So I wanted to share that. I wanted to share that there could be other things on formulary, that it is a biologic, it's a biosimilar, not a generic. And just to see what's on people's formulary if you need to do that. 

SARAH: Okay, thanks. Fantastic. Thank you for sharing those small pieces of information regarding insulin. And I think what else we wanted to talk about is needles. I know that and, and maybe how it comes like when, when the prescriptions are being written. I think some, there's some question about how is a prescription written, what do you need to write it for when we talk about insulin pens? So can you share anything or what would you like to share with us about that? 

DR. ADKINS: How does it come? It's such a good question. Like so how does it, how is it available?  And I think sometimes, right? Um, if you haven't seen it, so they actually come in boxes. The pens come in boxes and in each box there are five pens that are disposable.  For good or bad, they are disposable. And each pen has three milliliters, which is equivalent to 300 units. And in that box of five pens, that makes it 1500 units per box. So if you're ever writing prescriptions, you wanna know like how much is in there, how many boxes should I give, how many pens for a 90 day supply? That may give you some kind of context. And another thing I want to say about when prescribing pen needles for our patients is to not forget to put the needles on as a prescription. So oftentimes the needles are covered. 

SARAH: That's good to know 

DR. ADKINS: ...with the pens.

SARAH: That's so good to know. So what we're saying is when you prescribe a box of insulin pens, don't forget to prescribe those needles along with that. So just the pen needles that go on the top of that. So thank you so much Dr. Adkins for your time today. It was such a pleasure having this lovely conversation with such an intelligent, brilliant human

DR. ADKINS: Thank you. 

SARAH: So thank you. We're so grateful. 

DR. ADKINS: Thank you so much. I'm glad to be here and I'm happy you come back any day. 

SARAH: Thank you so much for having, watching this video of the QI Hub series and we hope to see you back again soon. It may not be as fun, but we'll be back.