Building Competency in Diabetes Education THE ESSENTIALS

BASAL-BOLUS INSULIN THERAPY | 12-95

Example:

Carbohydrates, g

7:30 AM breakfast

2 slices of toast 10 mL (2 tsp) jam 250 mL (1 c) 1% milk

30.0 10.0 12.0 0.0 52.0

Coffee

10:30 AM morning snack

1-35 g granola bar

28.0 6.0 34.0

125 mL (1/2 c) 2% milk

• For the person taking rapid-acting insulin, there would be two goals: 52 g carbohydrate at breakfast and 34 g carbohydrate at the morning snack. • For the person taking short-acting insulin, there would be one goal carbohydrate for the breakfast meal period: 86 g carbohydrate (52 + 34 = 86). 4. Aim for the goal carbohydrate. Keep a consistent carbohydrate intake when beginning IT to determine the insulin bolus. Carbohydrate intake should be within 5 g of each goal carbohydrate (120). This will make it easier to find the correct insulin bolus for a specific amount of carbohydrate. The goal carbohydrates should be eaten consistently until it has been determined how much insulin is required to achieve the patient’s goal BG. This dose is called the baseline dose. Consistent carbohydrate intake will also make it easier to determine the correct basal insulin dose. 5. Keeping food records will make it easier to achieve consistent carbohydrate intake. If the person’s BG is within the goal range for at least three days after meeting the goal amount of carbohydrate and taking a consistent amount of insulin, then the patient can incorporate some flexibility into meal planning by using a carbohydrate:insulin ratio. 6. Establishing the carbohydrate:insulin ratio: • A carbohydrate:insulin ratio is used to determine how much insulin to take for variable carbohydrate intake. Flexibility in the diet should not compromise BG if the ratio is used.