Basal Bolus - Basal Bolus Injection Regimen

Basal bolus involves injections at each meal
Basal bolus involves injections at each meal

A basal-bolus injection regimen involves taking a number of injections through the day.

A basal-bolus regimen, which includes an injection at each meal, attempts to roughly emulate how a non-diabetic person’s body delivers insulin.

A basal-bolus regimen may be applicable to people with type 1 and type 2 diabetes.

What is a basal-bolus insulin regimen?

A basal-bolus routine involves taking a longer acting form of insulin to keep blood glucose levels stable through periods of fasting and separate injections of shorter acting insulin to prevent rises in blood glucose levels resulting from meals.

What is basal insulin?

The role of basal insulin, also known as background insulin, is to keep blood glucose levels at consistent levels during periods of fasting.

When fasting, the body steadily releases glucose into the blood to our cells supplied with energy.

Basal insulin is therefore needed to keep blood glucose levels under control, and to allow the cells to take in glucose for energy. Basal insulin is usually taken once or twice a day depending on the insulin.

Basal insulin need to act over a relatively long period of time and therefore basal insulin will either be long acting insulin or intermediate insulin.

What is bolus insulin?

A bolus dose is insulin that is specifically taken at meal times to keep blood glucose levels under control following a meal. Bolus insulin needs to act quickly and so short acting insulin or rapid acting insulin will be used.

Bolus insulin is often taken before meals but some people may be advised to take their insulin during or just after a meal if hypoglycemia needs to be prevented.

Your doctor will be able to advise you if you have any questions as to when your bolus insulin should be taken.

Advantages of a basal-bolus regimen

One of the main advantages of a basal-bolus regimen is that it allows you to fairly closely match how your own body would release insulin if it was able to.

A second advantage of a basal-bolus regimen is that it allows for flexibility as to when meals are taken.

If you are self-adjusting your insulin doses, it means you also have flexibility over how much carbohydrate you take in for different meals.

Disadvantages of a basal-bolus regimen

One notable disadvantage is that a basal-bolus regimen involves taking more insulin injections each day. This may prove problematic in some people more than others.

Children on a basal-bolus regimen, for example, will need to feel comfortable with injecting at meal times when at school.

Basal-bolus regimen in type 1 diabetes

A basal-bolus regimen is popular amongst people with diabetes, particularly for working adults who may need to be flexible with when they take their doses and how much carbohydrate they eat.

People with type 1 diabetes will typically take rapid acting insulin at meal times and long acting insulin once or twice a day.

Basal-bolus regimen in type 2 diabetes

People with type 2 diabetes may be put onto a basal-bolus regimen if they experience significantly high blood glucose levels after meals and need to have a flexible insulin regimen to fit in with their lifestyle.

People with type 2 diabetes may take a combination of short acting and intermediate insulin, or may be put onto rapid acting and long acting insulin.

Blood glucose testing on a basal-bolus regimen

People on a basal-bolus regimen will need to regularly test their blood glucose levels through the day to monitor whether the correct doses are being administered.

Hypoglycemia can be a relatively common occurrence on a basal-bolus regimen so it is recommended to keep your blood glucose testing kit and a source of fast acting carbohydrate with you in case your blood glucose levels go too low.

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