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.
- 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.