Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-51

BBI calculations for people with type 2 diabetes in the 2018 Guidelines suggest 20% of TDD given three times per day as bolus (120).

Example : With a TDD of 38 units: 20% of TDD given three times per day as bolus. 38 x.2= 7.6 units, which may be rounded up to 8 units at breakfast, lunch and dinner.

A more precise way of calculating meal doses uses the carbohydrate to insulin ratio (CIR) for both BBI and CSII plans. This involves calculating CIR using individualized carbohydrate (CHO) estimates. See nutrition section later in this chapter for detailed information regarding calculating CIR. Carbohydrate consistency is important when starting any new regimen. It is important for the individual to commit to following a consistent meal plan (especially with respect to consistency in the amount of carbohydrate) while baseline doses are being evaluated. Flexibility with food intake should come after the baseline doses have been confirmed, since all of the supplements, and correction factors must be based on an accurate total baseline dose. Whether a 40-60 basal-bolus split, or a 50-50 basal-bolus split is used to calculate starting doses for BBI, it will need to be evaluated and adjusted. Typically, a 50-50 basal-bolus split is used to calculate the starting doses for CSII. See pump therapy later in this chapter for more detailed information.