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Basal/Bolus or is it Bolus/Basal or just Bolus/Bolus?

Mar 16, 2014

I had a new patient who has had diabetes for decades. She was referred to me after her blood sugars went from good to bad. I asked her to bring her supplies with her when she came in to the office for her appointment. She did so and during her visit, I asked her to demonstrate how to calculate basal and bolus insulin, how to draw up her insulin, and how to inject using her own supplies. I was completely surprised when….

I was completely surprised when she bolused with her long-acting Lantus and based her dose upon her prevailing blood glucose without regard to her food.

Lesson Learned:

As an endocrinologist we get referrals from primary physicians who do not feel they can manage a patient with erratic blood sugar. When a patient has blood sugars that are very different from their A1c’s or their regular blood sugars, it is always best to have them demonstrate their procedures.

J.M., MD

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