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Learning About Basal-Bolus Insulin Therapy in the Hospital

What is basal-bolus insulin therapy?

Basal-bolus insulin therapy is a series of daily insulin shots. If your blood sugar is too high while you're in the hospital, your doctor may order this treatment.

Insulin is a hormone that helps your cells use sugar (glucose) for energy. It also helps your body store extra sugar in muscle, fat, and liver cells. Without enough insulin, this sugar can't get into your cells to do its work. It stays in your blood instead. Your blood sugar level then gets too high.

It's the job of your pancreas to release insulin as your body needs it. When you're in the hospital, there are several things that can keep your pancreas from working right. These include:

  • Illness or injury.
  • The stress of being in the hospital.
  • Certain medicines, such as steroid medicines.
  • A change in your meal schedule.
  • I.V. or tube feedings.

Basal-bolus therapy works by releasing insulin into your blood the way a healthy pancreas would.

How is basal-bolus therapy done?

This treatment uses two types of insulin shots. The shots may be given with an insulin pen or with a regular needle.

  • Basal shot: This is long-acting insulin that you get once or twice a day. It gives a small but constant stream of insulin. This insulin helps process the sugar in your blood when you're not eating.
  • Bolus shot: This is short-acting insulin that you get at mealtime. It gives your body an extra burst of insulin. This insulin helps process the new sugar you get when you eat. You may get extra bolus shots between meals.

Your blood sugar will be tested 4 or 5 times a day to be sure it's not too high or too low.

If you have diabetes, you may already use insulin shots and have a target range. But in the hospital these may be different. After you leave the hospital, check with your doctor to see if your insulin routine needs to change.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

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