Basic bolus therapy

The basic bolus therapy (also the basic bolus concept ) describes the model of insulin therapy ( intensified insulin therapy , ICT for short) in diabetology for insulin-dependent diabetics with two different types of insulin . This tries to understand the natural curve of action of insulin secretion in healthy people.

Insulin action in healthy people

In healthy people, the islet cells of the pancreas continuously release insulin depending on the current blood sugar level and thus keep it in the physiological range. The blood sugar level rises shortly after ingesting carbohydrate-containing foods and then falls again when the blood sugar-active carbohydrates in the food are digested. In the case of quickly digestible carbohydrates (e.g. fruit juice, wine gum) it drops again quickly, in the case of slowly digestible carbohydrates (e.g. pasta, potatoes) or after a meal rich in protein or fat, the insulin level only drops after a longer period of time, depending on the delayed metabolism Time to get back to baseline. In addition, the blood sugar balance is influenced by various endogenous hormones.

Insulin effect through the basic bolus therapy

This active behavior is to be simulated by the basic bolus therapy . Two different insulin preparations are used for this : a long-acting one to ensure the basic supply ( base , → basal rate ) and a short-acting one, which is given with meals ( bolus ) to absorb the rise in blood sugar.

With the development of the very fast-acting insulin analogues in combination with long-acting insulins, it is possible to achieve an almost natural insulin level through the basic bolus therapy. It should be noted, however, that people consume fast-acting carbohydrates (high glycemic index) much faster than even the analog insulin unfolds its maximum effect. For this reason, it is advisable to maintain an interval of about 5 minutes between injection and eating when injecting insulin analogues, especially if the blood sugar level is slightly elevated. In this way, high postprandial values ​​(values ​​after eating) can be reduced. If the consumption of meals cannot be reliably planned, the analog insulins guarantee a relatively good effectiveness even after the meal has started.

The long-acting analog insulins have reduced the number of basal insulin injections required daily to up to once a day.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !