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There is a famous YouTube video in which a driver asks a passenger to determine the time it takes to travel 80 miles if one is traveling at 80 miles per hour (1). The passenger struggles with this concept despite the driver’s best efforts to review basic math principles and, in fact, never quite gets the idea. It is humorous because the passenger keeps introducing elements that really have nothing to do with solving the equation, and viewers (and the driver) find it impossible to believe that the passenger cannot do such simple math. We recently came upon a pediatric prandial insulin order set that had us wondering if health care providers (HCPs) handle this kind of math any better.This outpatient order set is an 11-page document written by providers with expertise in diabetes management and is intended for use by school nurses who manage diabetes and adjust insulin doses while children with diabetes are at school. It is administered via a widely used electronic health record that features a template to allow for consistency in order terminology. It also allows some flexibility in adjusting the specific details for a given order (e.g., to personalize a patient’s insulin-to-carbohydrate ratio). The basal dose of insulin is typically given at home, and there is a separate set of orders for programming prandial insulin dosing for those who use an insulin pump. This commentary only focuses on the prandial component. The pump and basal insulin orders will not be addressed. Depending on how a school manages diabetes for their students, the orders are engaged by either a nurse or a parent designated authority (PDA).For those not familiar with the PDA concept, a PDA is someone from the general public who volunteers during the academic year to help manage diabetes for a …

Prandial Insulin Dosing: How Long Does It Take to Go 80 Miles?