type-2 diabetes

Why is basal insulin needed?

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, with greater secretion at certain hours of the day, and less secretion at others. It is common for the liver to secrete extra glucose during the early morning hours. This is referred to as a “dawn phenomenon”.

•Offsets Hepatic Glucose Output

•Regulates Fasting Glucose

•Supplies Fuel for Basic Metabolism

•Usually approx. 50% of Total Daily Insulin

•Delivery options:

NPH, Glargine, Detemir, Insulin Pump

Thus, basal insulin’s job is to offset hepatic glucose output. Without basal insulin, the liver would secrete excessive amounts of glucose, and this glucose would remain in the bloodstream, causing damage to blood vessels and key organs. The body’s cells would starve for fuel, and ketosis or ketoacidosis could develop.

Why is “Bolus” Insulin Needed?

Food sources that traditionally affect the blood sugar are carbohydrates (such as sugars and starches). This includes potatoes, bread, rice, crackers and sweets. Proteins and fats do not generally affect the blood sugar unless consumed in large quantities on in the absence of carbohydrates.

It is important to note that all carbohydrates with the exception of dietary fiber, whether they be simple or complex, will ultimately be converted into glucose that enters the bloodstream.

Does the Type of Carbohydrate Matter?

•All carbs (except fiber) turn into blood sugar eventually

Various types of carbohydrate have slightly different effects on your blood glucose levels due to what they’re made of, how they’re processed, whether or not they’ve been cooked, and whether you eat them alone or in combination with other foods.

•Some carbs turn into blood sugar faster than others

It’s often difficult to predict how different carbohydrate foods affect your blood glucose because there are so many variables. Some people, however, can identify certain carbohydrate foods that have a faster or slower effect on their blood glucose levels than others (known as the glycemic effect of foods).

•The faster it works, the harder it is to control blood sugar

Glycemic index is a score given to foods based not on how much, but how quickly individual foods raise blood glucose levels.

Foods with high-glycemic index scores (causing a rapid blood glucose rise) include potatoes, rice, cereal, bread, and sugary candies.

Foods with low-glycemic index scores include pasta, legumes, dairy products and chocolate (due to its high fat content).