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NOTE: For an algorithm to work you<br />
need to eat the same amount of food<br />
and carbohydrate every day. (If you<br />
always have a sandwich with 2 slices of<br />
bread, a piece of fruit, a glass of milk<br />
and a small bag of chips for lunch, this<br />
method will be fine.) If you eat a big<br />
salad one day and a plate of spaghetti<br />
the next, these foods have different<br />
effects on your blood glucose and you<br />
would need different doses of insulin, so<br />
this is not the best way for you to decide<br />
how much insulin to take before meals.<br />
Basal <strong>Insulin</strong> – Works steadily day<br />
and night to keep your blood glucose<br />
within your goal levels. Taken as an<br />
injection, basal insulin is long acting and<br />
works around the clock. Taken via insulin<br />
pump, a very small amount of basal<br />
insulin is released constantly at fractions<br />
of a unit per minute. The goal is to<br />
match the amount of insulin with the<br />
low level of glucose produced by your<br />
liver. This helps your blood glucose levels<br />
remain stable day and night - even if you<br />
don’t eat anything. Types of basal insulin<br />
include:<br />
• Long-acting insulin such as insulin<br />
glargine (Lantus ®) is often used for<br />
basal insulin because they last a long<br />
time and have no peak action.<br />
• Ultralente - occasionally used as<br />
basal insulin, does have some peak<br />
action. (See Peak Action.)<br />
• Short or rapid-acting insulin (see<br />
below) given by an insulin pump –<br />
tiny amounts of rapid acting insulin<br />
are delivered throughout the day<br />
and night. This is the best example<br />
of basal insulin and may be closest<br />
to imitating the way the pancreas<br />
normally works. Another advantage<br />
is that basal rates on a pump can<br />
be changed to meet your needs at<br />
different time periods of the day<br />
and night.<br />
Bolus <strong>Insulin</strong> – Taken before you<br />
eat and to correct for a high blood<br />
glucose, it is released in a squirt or pulse.<br />
This allows the insulin to provide a rapid<br />
burst of action. Bolus insulin acts as the<br />
“extra” insulin that is released by a<br />
normal pancreas to help your body use<br />
the glucose from a meal or snack. The<br />
extra insulin will bring your blood glucose<br />
levels down before they climb too high.<br />
Types of Rapid-acting insulin used for<br />
bolus insulin are:<br />
• <strong>Insulin</strong> Lispro (Humalog ®), <strong>Insulin</strong><br />
Aspart (Novolog ®), <strong>Insulin</strong> glulisine<br />
(Apidra) or<br />
• Regular insulin, which is referred to<br />
as a short-acting insulin.<br />
6
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