Basal Insulin Options

In the past, basal insulin was provided by NPH (a twice per day injection). But as you can see, it does not mimic the actual insulin output of a fully functioning pancreas. As advances in medicine were made, the development of long acting insulins, like glargine and detemir came about, which provided a consistent and steady release of insulin over a 20-24 hour period. However, when comparing this to the insulin pump basal delivery system... The pump is best able to mimic normal basal insulin requirements, therefore providing the best chance at normoglycemia.

As you can see, NPH taken only in the evening has the potential for causing hyoglycemia during the night, and rising glucose levels late in the day.

NPH taken twice daily (including use of premixed insulin twice daily) is counter-intuitive to normal physiology.

Use of glargine or levemir comes closer to matching normal physiology, but there are still some potential problems: rising glucose during the night, and falling glucose during the day.

Because the rate of basal insulin delivery on an insulin pump can be adjusted by the user, pump therapy offers the best opportunity to truly match normal physiology.