Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-22

Basal-bolus insulin regimens

Figure 3. BBI using 4 or 5 injections/day: Rapid/short and intermediate-acting insulin

• Type and timing

o Rapid/short acting insulin prior to breakfast, lunch and dinner. o Intermediate-acting insulin at 10:00 PM only or NPH/N insulin twice daily, at breakfast or lunch and bedtime. • Benefits o There is more flexibility to accommodate changes in food and activity. o The regimen is easy to understand. o The patient can correct BG that is out of target more quickly. o For those without coverage, NPH/N is less expensive. • Limitations o This regimen requires the motivation for four to five insulin injections/day. o Some patients using rapid-acting insulin with meals may run out of insulin between meals and BG may rise. A second dose of intermediate-acting insulin given in the