Type 1 Type 2 on Insulin

Basal and bolus basics

What is basal insulin?  We through this term out there to our patients all the time.

What basal are you taking?  We’re going to start you on a basal insulin.  You can take your basal anytime of the day.  Basal, basal, basal. What does it mean?

Well, let’s take a normal patient who does not have diabetes.  Let’s make this patient a college kid who parties and pulls an all nighter and then crashes for 16 hours.  He sleeps for 16 hours.  He’s not dead, just sleeping.  Well, if he’s staying at home, his mother will argue about that with you.

Anyway, imagine him sleeping.  His brain, heart, lungs, all of his organs are still functioning and working.  Well, these organs need sugar to work.  Where does the sugar come from?  Mainly, it comes from the liver.  The liver just makes sugar all the time, especially when sleeping or fasting.  This sugar has to go to these organs and in order for the sugar to go into the organs, we need insulin.

The pancreas is making insulin all the time.  Just like the heart beats all the time, the pancreas is cranking out insulin constantly.  This constant cranking no matter what is called the basal.

In order to understand the basal better, you have to understand a bolus.

Imagine this kid wakes up and what’s the first thing he’s going to do?  He is going to eat!  Now, imagine you are the pancreas.  You “see” this food coming down and you are already making some insulin, the basal, but now you have to make a huge amount… right NOW.  All at once.  This my friends, is the bolus.  These boluses are for meals.

Some people just need a basal insulin and they can do without a bolus, others need both a basal and a bolus.  It just depends on what is going on to your body and what medications you are already taking.

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