- Insulin is indicated for patients with Type 1 diabetes and those with Type 2 diabetes not adequately controlled by diet and oral antidiabetic agents, or during intercurrent illness.
- Prescribe by brand name rather than generically since it is not safe to assume that similar preparations from different manufacturers will have identical effects in practice.
- Do not abbreviate 'unit' on prescriptions as errors may occur, e.g. 10U may be mistaken for 100.
- Insulin vials should not be shared between patients. Use one vial per patient.
- Bovine and porcine insulins are no longer recommended formulary choices for initiation but may be prescribed for patients already established on therapy.
- Apidra (insulin glulisine) may be used for patients using an insulin pump or those already using the Solostar device.
- U500 insulin is an unlicensed insulin that is 5 times more concentrated than standard insulin (U100). It should be prescribied in 'marks' and administered with a 0.3ml or 0.5ml insulin syringe only (in which 1 mark represents 5 units of insulin). This insulin is usually supplied from UHL pharmacies.
- The NPSA have issued a Rapid Response Report for the safer use of insulin. See here for the report.
Devices for formulary choices
|| Pen for cartridges
|| Prefilled Pen|
|| HumaPen Savvio
| Novo Nordisk
|| Novopen 4
| Sanofi- Aventis