Instructions
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Basal Insulin
The micro-dosing of basal insulin can be adjusted hourly to most closely balance the body’s metabolic needs and liver glucose output. These dosage settings should be tailored to meet the differing needs that most people see at different times of day. This greatly reduces the risk of the overnight hypoglycemia we often see with long-acting insulin, as well as reducing daytime hypoglycemia if meals are skipped.
Hormonal Influences on Hepatic Glucose Secretion The amount of glucose produced by the body is dependent on several factors, including hormones. Many hormones, include glucagon, adrenaline (epinephrine), noradrenaline (norepinephrine), cortisol, growth hormones and sex hormones stimulate the liver to produce glucose. This, in turn, creates the need for ongoing “basal” insulin. In most people, the liver secretes glucose in a diurnal manner, meaning glucose is secreted in greater secretion at certain hours of the day, with less secretion during others.
Bolus Insulin Bolus insulin is a much larger dose of insulin delivered to cover meal related blood sugar needs and to correct elevated blood sugars. These are calculated using bolus ratios such as a carb to insulin ratio and a correction factor or insulin sensitivity factor. Insulin pumps all have an onboard bolus calculator that stores this data allowing for reduced burden of arythmatic through one’s day Using a calculation for the duration of insulin action these calculators also allow for bolus doses to be tracked and subsequent doses to be reduced, greatly avoiding risk of hypoglycemia.
There is also the benefit of the ability to deliver very small doses of insulin for different meal sizes or small corrections.
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