Bolus Vs. Basal - 30 Health Posts in 30 Days

I still get confused with the two words bolus and basal.  Every time someone says one of those words I have to stop and remember which one is which.  Giving yourself a bolus is when you eat something and you have to give yourself some insulin to take care of it, or when you need to make a correction to your blood sugar level because you are too high, then you bolus (take more insulin).  Each person has a different ratio for this.  When I need to bring my blood sugar level down, I take one unit of insulin for every 30 points I want to lower my blood sugar.  When I eat, I take 1 unit of insulin for every 8 carbs I eat.  There is a lot of math going on here, but thank goodness for pumps that can figure it out for you when you program your ratios into the pump!!!

A person's blood sugar level normally just increases throughout the day, so since my pancreas doesn't work, I have to have a steady stream of insulin going into me at all times.  This is also different for each person AND for each person it is a different amount during different times of the day.  Like during the night my pump delivers  about one unit of insulin over the time period of an hour, for about 8 hours, then during the morning hours there is a different amount of insulin going in for a few hours and then the rest of the day is a different amount again.  This can get tricky because if you change your schedule or something is going on with your hormones, then the amount of insulin you need at certain times can change.  It is a REALLY fun game trying to keep up with it.  And this stream of insulin going through a pump into my body is the basal.

Now one would think that if you have your basal down and your bolus correct, that when you eat everything should work out just perfectly, right?  WRONG.  Sometimes you can be wrong with the carb intake and go high or low, sometimes you have more or less physical activity which you have to adjust for and then there is my favorite.  When I eat something fatty, my blood sugar level will keep on increasing for hours and hours after eating.  Therefore, I keep checking my blood sugar levels and even though I have taken the correct amount of insulin for the carb intake, my blood sugar just keeps on going up, and then I take more insulin and check an hour later and it still hasn't moved or it has just increased again.  Drives me crazy.  However, there is this little function on my pump called the dual wave bolus.  This means that I can set it so that when I eat, it gives me the correct amount of insulin I need to take for the carbs I am eating right then, and then I can also program it to give me the "dual portion" which is me saying to my pump "please deliver an extra unit of insulin each hour for five hours" so that it takes care of the fattiness that is driving my blood sugar up for the next few hours.  Now this is great and good and all, but first off, it is hard to remember to actually do it and secondly, there is no exact science as to how long the fatty food will be affecting my blood sugar levels or even how much higher the food will make my sugar levels as well.  So, each time, it is just a shot in the dark, but heck, when it works well, it is very much so worth it!!

This post was written as part of NHBPM – 30 health posts in 30 days: http://bit.ly/vU0g9J