Carbohydrate Counting Page 10
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48Basal-Bolus Insulin and Carbohydrate Counting
How Multiple Daily Injection (MDI) works
When using MDI, you take both basal insulin and bolus insulin.
Total Daily Dose (TDD) comes from adding up both basal and meal
(carbohydrate) bolus baseline doses.
These things may affect the action of rapid acting insulin:
• The site used. Insulin injected into the thigh or buttock may be slower
to start working than a dose given in the abdomen.
• Scarred areas from overused injection sites (called hypertrophy)
will change absorption.
• The blood flow to a site is increased with exercise or extreme heat.
• The larger the dose of insulin used, the longer the duration of insulin
will be. A larger dose lowers blood sugar for a longer period of time.
For basal insulin:
• You take this insulin once or twice a day.
• The amount will depend on what you need over the day and night.
• The dose of this insulin does not change on a day to day basis.
• This insulin should be taken even if you are not eating or drinking,
unless otherwise discussed with your diabetes educator.
For bolus insulin:
• You take rapid acting insulin before you eat or drink carbohydrates.
• You can change this dose to match the changes in the carbohydrate
amounts you eat and/or drink.
• An insulin to carbohydrate ratio is used to match the carbohydrate
(carb) content of food and/or drinks. One unit of rapid acting insulin will
match to a certain amount of carbohydrate.
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