Feature Article

Type 1 diabetes: insulin schedules for adults

Feature Article

Type 1 diabetes: insulin schedules for adults

Pat Phillips, Jessica Phillips

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Abstract

Basal–bolus, premix and self-mix are the common insulin schedules used in adults with type 1 diabetes, and offer varying degrees of flexibility and convenience. Episodes of hyper- and hypoglycaemia, periods of sickness and travel by air may require adjustments to insulin schedules.

Key Points

  • Type 1 diabetes should not be confused with type 2 diabetes requiring insulin or late onset autoimmune diabetes of adults.
  • Blood glucose swings in people with type 1 diabetes are considerable, with 10% of values lying from 30 to 60% above and below the 24-hour average blood glucose levels at A1c values between 5.0% and 9.1%.
  • The three components of insulin schedules are the ‘Bs’ – 24-hour Basal, mealtime Bolus and corrective Boosts.
  • The three common insulin schedules are basal–bolus (also known as multiple daily infection), premix and self-mix. These offer varying degrees of flexibility and convenience, with basal–bolus the most flexible but least convenient and premix the most convenient but least flexible.
  • Common problems with insulin therapy include hypoglycaemia; glycaemic and fluid and electrolyte disturbances in sickness; and the need for adjustment after air travel.