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Changing to basal and bolus

B

Big_Col

Well-Known Member
Messages
61
Type of diabetes
Type 1
Treatment type
Insulin
Had my first appointment with a DSN in 19 years last week.

Obviously, things have moved on the meantime. I'm currently on Humulin I, once a day, and S three times.

Is there any advantages in changing to a basal and bolus regime?
 
Essentially Yes! Basal/bolus allows you to flex what you eat and when. However the other side of the coin is that you have to take responsibility for carb counting, dose adjustment and testing to make it all work.
 
That's pretty much what I'm doing now, without the carb counting.

Sounds like a lot of hassle for little gain.
 
Sorry had misread the earlier post, your combination certainly qualifies as basal/bolus. What is it the DSN actually wants to change?
 
Big_Col said:
Had my first appointment with a DSN in 19 years last week.

Obviously, things have moved on the meantime. I'm currently on Humulin I, once a day, and S three times.

Is there any advantages in changing to a basal and bolus regime?
Click to expand...

Is that not already basal/bolus?

If your DSN means changing you to analogue (very fast acting) insulins, then that would be up to you. Don't be pushed into any change you don't need or want.

I changed to analogue insulin 13 years ago, but then went back to regular insulin. We're all individuals and not all insulins suit all people.
 
Was under the impression that basal/bolus was a background Insulin with a top up when you eat. That's not how I take it.
 
Big_Col said:
Was under the impression that basal/bolus was a background Insulin with a top up when you eat. That's not how I take it.
Click to expand...
Basal is the long acting insulin that deals with the "trickle of glucose" dumped by the liver even when you're not eating, anywhere from 12 to 24 hours depending on the kind. Basically the energy we're using between meals is being dealt with this way.

Bolus is the fast acting insulin that deals with the glucose (foods that get converted to glycose) you eat, immediately when you eat it.

Humulin I and S *should* be taken this way for the most effective treatment of insulin dependent diabetes. How do you currently use it?
 
The day is split into 4 periods which each injection covers.
 
Hi. It sounds like what you are already doing is a form of Basal/Bolus. Are you using a pen or vial? If it was me I would get up to date with the popular insulins for Basal/Bolus e.g. Levemir (which is NICE preferred) and probably Novorapid unless there are contra-indications. These would be for use with cartridge pens or disposable pens. There are other insulins where there are problems. BTW you should be having annual reviews and blood tests etc if in the UK.
 
Big_Col said:
The day is split into 4 periods which each injection covers.
Click to expand...

Ok So a form of basal/bolus with a long acting insulin, then fast acting before meals.

Are you on set doses of your meal time insulin or do you adjust the amount according to the carbs you're about to eat?

It's not clear whether the nurse is using basal/bolus to mean adjusting doses or to mean faster acting insulins. I'd check,exactly what the proposed insulins and injectiin schedule would be, and ask the nurse why it's being recommended to,you.

If you're happy as you are and your control is good, then don't be pushed into a change you don't want
 
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