Insulin Clinics / Special situations

Questions for your clinician

A printable checklist organized by appointment type. Pick the section that fits your visit and bring the questions that matter to you.

Medically reviewed by [Name, MD] · Last reviewed: [Month YYYY]

Starting insulin

• Why are we starting insulin specifically, instead of (or in addition to) other options?
• Which insulin will I be taking — name, type, and how does it fit into my day?
• What is my starting dose and how was it chosen?
• What time of day should I take it, and how strict does the timing need to be?
• Should I take it before, during, or after meals?
• What does a typical first-month adjustment plan look like?
• What blood glucose readings am I aiming for? Fasting, before meals, after meals, bedtime?
• How often should I check, and which times of day matter most?
• Will I be using a continuous glucose monitor, and if so when do I start?
• What pen, syringe, or device do I need, and how much does it cost?
• Can you walk me through an injection in person before I leave?
• How do I store this insulin at home and when traveling?
• What are the warning signs of a low blood sugar I should watch for?
• Should I have a glucagon prescription, and which kind do you recommend?
• What should I do if I miss a dose?
• What should I do if I take the wrong dose?
• What should I do if my blood sugar is over a certain number — what number, and what action?
• When should I call you, and through what channel?
• When is my next follow-up?

Routine follow-up

• What is my A1C and how does it compare to my goal?
• What does my time in range look like over the past 2–4 weeks?
• What patterns do you see in my glucose data that I should know about?
• Are my doses still right, or do they need adjusting?
• Are my injection sites looking healthy? Any signs of lipohypertrophy?
• Are there changes I could make that would reduce my low blood sugars?
• Are there changes I could make that would reduce my highs after meals?
• How is my kidney function, and does it affect my regimen?
• When was my last eye exam, and am I due?
• How is my blood pressure and cholesterol? Do they need treatment changes?
• Are there any newer insulins, devices, or systems I should consider?
• Is there a less expensive equivalent of what I am using?
• Am I getting flu, COVID, pneumonia, hepatitis B, and shingles vaccines as recommended?
• What is my plan if I get sick?
• What is my plan for travel or schedule changes?
• Should I be checking ketones at home, and how often?

When something has changed

• I have been having more lows than usual — what could be driving them?
• I have been running higher than usual — what could be driving it?
• I have lost or gained weight — does my dose need to change?
• My readings have become unpredictable — could this be an injection site or device problem?
• I have started a new medication elsewhere — does it interact with my insulin?
• I have changed my work schedule or shift — how should I adjust?
• I have started exercising more (or differently) — how should I adjust around it?
• I have started or stopped drinking alcohol — what do I need to watch for?
• I have lost a low symptom I used to have — what does that mean?
• I have had a severe low or used glucagon — what do we change?
• I have moved or my insurance changed — what is the cheapest equivalent of my regimen?
• My pump or sensor is failing more often — what backup plan should I have?
• I am newly diagnosed with another condition (kidney, thyroid, heart, depression) — does it affect my insulin plan?

Before pregnancy or trying to conceive

• What A1C should I aim for before stopping contraception?
• Which of my medications need to change before pregnancy?
• Which insulins are recommended for me during pregnancy?
• Should I be on a CGM or pump for pregnancy if I am not already?
• What folic acid dose do you recommend, and starting when?
• When should I have an eye exam and a kidney check?
• Who will be on my care team during pregnancy — endocrinology, MFM, OB?
• What blood glucose targets will I be aiming for in each trimester?
• How should I respond to lows differently in early pregnancy?
• What is the plan for adjusting insulin around delivery and after?
• Will I be able to breastfeed safely, and how does it affect my doses?
• What screening should I have postpartum, and when?

Before surgery or a procedure

• Should I take my basal insulin the morning of surgery? At what dose?
• Should I take my mealtime insulin if I am NPO?
• If I use a pump, does it stay on during the procedure?
• If I use a CGM, does it need to be removed for any imaging?
• What target blood sugar will the surgical team aim for during and after?
• What should I do if my glucose runs high or low while I am NPO?
• How will my insulin be managed during the hospital stay?
• What should I bring with me — pens, infusion sets, sensors, glucagon?
• How will my regimen change during recovery, and for how long?
• When can I resume my usual doses?
• Are there post-op medications (steroids, painkillers) that will affect my glucose?
• When will I follow up to readjust insulin doses?

Cost and access

• What is the cheapest equivalent option for my current insulin?
• Is there an authorized generic or biosimilar version?
• Is there a manufacturer copay card I qualify for?
• Do I qualify for the manufacturer's patient assistance program?
• Could ReliOn (or another lower-cost regimen) work for me, and what would change clinically?
• Could you help me appeal a denied prior authorization?
• Could you give me a few days of samples while we work this out?
• Is the dosing or timing of any of my current medications flexible enough to reduce cost?

Questions about your team and how to reach them

• Who do I call after hours for an urgent insulin question?
• What counts as urgent enough to call vs send a message?
• How quickly do you usually respond to portal messages?
• Can I send CGM or meter data ahead of visits?
• Who is my backup if you are out of office?
• Do you have a diabetes educator I can also see between physician visits?
• Are virtual visits an option for routine adjustments?