Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-5

WHAT IS INTENSIVE THERAPY?

Intensive therapy, or as it is now referred to as intensive treatment (IT) in Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes Canada (2018 Guidelines) is a system of matching insulin doses to food, activity and life events using individualized adjustment guidelines based on glucose results (1). It is generally accepted that IT means basal-bolus insulin therapy (BBIT). It is accomplished with either basal-bolus injections (BBI), also known as multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII) , also known as insulin pump therapy. Critical self-care behaviours required for IT include the following (2): • Taking basal insulin with the addition of a preprandial insulin bolus with each meal. • Using a carbohydrate counting system. • Adjusting insulin for carbohydrate for each meal. • Adjusting insulin and/or food for activity. • Adjusting insulin and/or food for BG targets (correction bolus). • BG monitoring: three or more times/day. • Pattern management adjustments as needed.