For last week’s practice question, we quizzed participants on counting every pen(ny.) 47% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question: KL takes 5-10 units of insulin glulisine (Apidra) based on an insulin scale before each of their 3 daily meals and 30 units of glargine (Basaglar) at bedtime.

Based on this information, how many u-100 glulisine (Apidra) insulin pens would KL use a month?

Answer Choices:

1. 2 vials
2. 4 pens
3. 6 pens
4. 3 pens

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Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements, get rid of false answers, do any math very carefully and choose the BEST answer.

Answer 1 is incorrect. 6.31% chose this answer. “2 vials.” One way to quickly eliminate a wrong answer is to see if the units in the question match the units in the answer. The question asks, “How many pens” would JR need a month and this answer is in “vials”. We can cross this one off as false. **See complete math explanation below.

Answer 2 is correct. 46.64% of you chose this answer. “4 pens.” YES.. Great job. You not only calculated JR’s insulin needs, but added in extra insulin for priming too! **See complete math explanation below.

Answer 3 is incorrect. About 16.24% of respondents chose this. “6 pens.” This was a juicy answer that lured respondents into adding together the glulisine and glargine dose. The answer only asks for how many glulisine pens would JR need a month. **See complete math explanation below.

Finally, Answer 4 is incorrect. 30.82% chose this answer. “3 pens.” This was the juiciest answer of all. However, it doesn’t take into account the 2 units of insulin used to prime the pen before each injection. Also, if they had 3 pens of 300 units each, what if they made a mistake or wasted a dose, or needed a little extra.. they might be short on insulin. We always want to allow for a little cushion, just in case. **See complete math explanation below.

**Complete explanation – Doing the math.
If JR takes 5-10 units of insulin glulisine (Apidra) 3 times a day, we have to assume they will be taking the highest dose each time, so they don’t run out of insulin. That means JR uses 30 units a day of glulisine. 30 units a day x 30 days in a month = 900 units. But wait, JR needs to prime the pen first with a 2 unit “air shot” before each injection to make sure insulin is flowing through the needle before each of their 3 injections. So this means that JR is using up to 12 units of insulin 3 times a day or 36 units x 30 days = 1,080 units of glulisine a month. The next thing we need to know is that each U-100 glulisine pen holds 300 units of insulin (see our Insulin Storage Cheat Sheet 2023). Now, we can do the math. JR uses 1,080 units of insulin a day. Since each pen holds 300 units, we take 1080 and divide by 300 for a total of 3.6. This means JR will need 4 pens of glulisine each month to manage their diabetes.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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