Insulin Therapy with Basal-Bolus Approach: Utilization, Advantages, and Potential Drawbacks
Managing diabetes requires careful balancing of insulin levels in the body, and two popular methods for achieving this are Basal-Bolus Insulin Therapy and Automatic Insulin Pumps with Continuous Glucose Monitoring (CGM).
**Basal-Bolus Insulin Therapy** is a method that delivers insulin in two main ways: Basal Insulin and Bolus Insulin. Basal Insulin, a continuous, background infusion, mimics the body's natural insulin production and maintains stable blood glucose levels throughout the day and night. Bolus Insulin, on the other hand, involves additional, one-off doses of insulin taken before or after meals to manage blood glucose spikes. This method can involve injections or an insulin pump for delivery, with the user manually adjusting doses based on blood glucose levels and food consumption.
**Automatic Insulin Delivery (AID) Systems**, combining an insulin pump with a continuous glucose monitor (CGM), automatically adjust insulin delivery based on real-time glucose readings from the CGM. This reduces the need for manual adjustments, improving time in range, and decreasing the mental burden of managing diabetes. Key features of AID systems include automated basal and bolus adjustments, improved time in range, and reduced user burden.
A comparison of the two methods reveals that while Basal-Bolus Therapy involves manual adjustments of insulin doses, an Automatic Insulin Pump with CGM provides continuous monitoring and automated adjustments, offering a more precise and less burdensome approach to diabetes management. People using Basal-Bolus Insulin Therapy also need to use Bolus Insulin at meal times, and examples of rapid-acting insulins include aspart (Novolog), lispro (Humalog), and glulisine (Apidra).
Insulin pumps deliver insulin through a catheter that the person tapes in place on the skin and typically have to be worn at all times. Devices are now available that constantly monitor glucose and either automatically administer insulin, serving as an artificial pancreas, or notify the user when to apply shots through a pump. Some "smart" pumps connect to phone apps to make administration easier; some also record blood glucose data and provide reports directly to the doctor.
Basal insulin, or "background insulin," is taken once or twice a day to keep blood sugar levels consistent, while Bolus Insulin, known as "rapid-acting" insulin, works in about 15 minutes, peaks in about 1 hour, and continues to work for 2 to 4 hours. Carbohydrate counting and insulin-to-carbohydrate ratios are important tools for people with diabetes who use insulin, as Bolus insulin needs to reflect the amount of food a person eats during a meal.
Basal-Bolus Insulin Therapy reduces A1C, or average blood sugar levels, over a more extended period and further than other treatments without significantly increasing the risk of hypoglycemia, or low blood sugar. Examples of long-acting basal insulin for people with diabetes include glargine (Basaglar or Toujeo), detemir (Levemir), and degludec (Tresiba).
Insurance plans differ around how a pump might be covered and the amount of co-payments you may be responsible for. It is advisable to contact your insurance member services desk to ask about coverage options. This type of treatment might also be helpful for people who work shifts or travel across time zones regularly. Some people might take only basal insulin, which is a long-acting insulin that boosts activity for around 24 hours at a time.
In conclusion, both Basal-Bolus Insulin Therapy and Automatic Insulin Pumps with CGM offer effective methods for managing diabetes. The choice between the two depends on individual preferences, lifestyle, and specific diabetes management needs. It is essential to consult with a healthcare professional to determine the most suitable treatment option.
- Managing diabetes requires maintaining proper insulin levels in the body, which can be achieved through Basal-Bolus Insulin Therapy and Automatic Insulin Pumps with Continuous Glucose Monitoring (CGM).
- Basal-Bolus Insulin Therapy involves Basal Insulin and Bolus Insulin, helping to maintain stable blood glucose levels and manage spikes.
- Basal Insulin, a continuous infusion, replicates the body's natural insulin production, functioning throughout the day and night.
- Bolus Insulin, administered before or after meals, regulates blood glucose spikes, and can be delivered through injections or an insulin pump.
- Automatic Insulin Delivery (AID) Systems, consisting of a pump and CGM, automatically adjust insulin delivery based on real-time glucose readings, reducing manual adjustments.
- AID systems have features such as automated basal and bolus adjustments, improved time in range, and reduced user burden.
- People using Basal-Bolus Insulin Therapy must use Bolus Insulin at meal times, with rapid-acting insulin options including aspart (Novolog), lispro (Humalog), and glulisine (Apidra).
- Insulin pumps deliver insulin through a catheter on the skin and require constant wearing.
- Devices now exist that constantly monitor glucose and automatically administer insulin or notify users when to take shots through a pump.
- Smart pumps connect to phone apps for easier administration, and some also record and report blood glucose data to doctors.
- Carbohydrate counting and insulin-to-carbohydrate ratios are crucial tools for people who use insulin to manage diabetes.
- Basal insulin keeps blood sugar levels consistent, while Bolus Insulin, or rapid-acting insulin, works in 15 minutes, peaks in 1 hour, and continues for 2 to 4 hours.
- Examples of long-acting basal insulin for diabetes management include glargine (Basaglar or Toujeo), detemir (Levemir), and degludec (Tresiba).
- Insurance coverage options for pumps and co-payments may vary, so it is recommended to contact your insurance member services for more information.
- These treatments might be beneficial for individuals who work shifts or travel across time zones regularly.
- In choosing between Basal-Bolus Insulin Therapy and Automatic Insulin Pumps with CGM, it's essential to consult with a healthcare professional to determine the most suitable treatment based on individual preferences and lifestyle.
