Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6-98

carbohydrate intake, and to correct high BG before dinner. o Long-acting basal insulin analogue or intermediate insulin in evening (10:00 to 11:00 PM). o Able to adjust basal and dinner bolus insulin dose to achieve glycemic targets without increasing risk of nocturnal hypoglycemia. • Limitations: Good control during the day is difficult to achieve. May need between-meal snacks.

Continuous Subcutaneous Insulin Infusion (CSII): Insulin pump Figure 9. CSII: insulin pump

• Insulin type and timing:

o Rapid-acting insulin is given on a continual basis, mimicking pancreatic basal insulin secretion. The prandial “bolus” insulin dose is dependent on the blood/interstitial fluid glucose level, carbohydrate intake, and planned activity.

• Benefits:

o Provides significantly increased flexibility in meal timing, as basal insulin is delivered continuously. o Less day-to-day variability in insulin absorption.