Basal/Bolus

[fred1234]

Hi everyone
I am sorry about this lengthy post but beside myself
My gp speakng to cons at hospital about changing insulin from novomix30 8 units injected at lunch time to basal/bolus???? I am type2. I am on daily maintenance dose of 20mg of steroids for other medical condition. This plays havoc with my b.s.. I monitor bloods before and 2 hrs after every meal. From lunch time until early evening I feel absolutely rotten. B.s. climb into teens even after injecting and don't come back to normal until late evening. Then I'm starving but manage to have light supper and then it's bed. Fasting normally in the 5s.

I have been up all night crying my eyes out as I can't even begin to understand this new regime never mind implementing it!!!! I am terrified....worried bout hypos etc. How am I going to adjust to this. I've looked at the link but feel I am even more confused.

 

[Mrsass]

Hi @fred1234

the basal and bolus should help with your highs and feeling rotten which are the important things here.

I bet you felt this way when first being put onto injections or first being diagnosed?

We are always scared of the unknown but once you know how it is very easy to manage. once your doses are correct, which will take a little bit of trial and error and lots of testing you should feel better in yourself and be getting great readings. Try not to worry as it won't be doing your bg any good, have a read around the forum at other posts like this

Abbie

 

[teacher123]

Hi there @fred1234 and sorry to hear about your concerns and worries.

Basal simply means the background insulin (ba for back is how I remember) and this can be taken in the morning or evening, usually one injection.

Bolus is the insulin required before each meal so as @Mrsass it will take time to understand what works best for you in terms of foods, ration but you will grow in confidence don't worry. It's a great regime because it gives you greater flexibility and don't have to eat at the same time every single day.

Let us know how you're getting on once you start it

 

[noblehead]

There's a good explanation on the community pages of DCUK about a basal/bolus insulin regime:

http://www.diabetes.co.uk/insulin/basal-bolus.html

 

[Daibell]

Hi. If you have bs control problems you should welcome Basal/Bolus. I'm on it and it gives the best control. Yes, you have two insulins and yes there are more injections per day but once you get the dosage right you can avoid hypos with a bit of luck; I haven't had one in 2 years. I typically have 3 injections per day i.e. 1 of daily Basal and Bolus at lunch and dinner. Many are told to split their Basal (as it doesn't last the full 24 hours) and have Bolus for breakfast which makes 5 injections. So, if you have a low-carb breakfast you can keep down to 3 injections. My last HBa1c was 6%. Do come back if you need anything clarified.

 

[Dizzydog]

I take maintenance dose of pred 25mg currently and anywhere up to 60mg. I use basal/ bolus and it was the best decision I made to change from pre-mixed and much better control.

Steroids give the exact pattern regarding blood sugars you describe. They will push up blood sugars from late morning and then come down again over night. With steroid diabetes discuss the option that the basal insulin be taken in the morning rather than the evening which is the normal to avoid the potentional of overnight hypo and to match the effects of the steroids. This is what I was advised to do & works really well. I use levemir as my basal once a day in the morning and then novo rapid with meals, I also carb count and your likely find your ratio will be different for each of the three meals. Because of the steroid effect on blood sugars my lunchtime insulin to carb ratio is much worse than any other time of the day.

Hope this helps and I feel basal/ bolus has been so much better and gives me greater flexibility and control. It's also more flexible as you can adjust with any changes in steroid dose (mine changes often) and you will soon learn how much you personally need to adjust by

 

[Mrsass]

Hi there @fred1234 and sorry to hear about your concerns and worries.

Basal simply means the background insulin (ba for back is how I remember) and this can be taken in the morning or evening, usually one injection.

Bolus is the insulin required before each meal so as @Mrsass it will take time to understand what works best for you in terms of foods, ration but you will grow in confidence don't worry. It's a great regime because it gives you greater flexibility and don't have to eat at the same time every single day.

Let us know how you're getting on once you start it

@teacher123 I like your way of remembering basal, I used to remember bolus as the one to take with my food as bowl(us) If that makes sense lol