Bolus is the term used for describing the administration of a discrete amount of a prescription drug in order to raise its concentration in blood to an effective level.
Bolus Insulin – is rapid acting insulin that is administered for correcting high blood sugars or for the consumption of carbohydrates. Did you bolus for dinner? Translates to, “did you give yourself insulin for the carbohydrates that you are going to consume at dinner?”
Basal/Background Insulin – is long acting insulin (rapid acting insulin for pump users) that is administered once or twice daily to convert the glucose that is created by our bodies naturally into energy. The basal insulin attempts to emulate how a person without diabetes delivers and manages insulin throughout the day. The basal insulin’s job is to keep blood glucose levels at consistent levels during periods of fasting.
Bolus Methods
Pre-bolusing – rapid acting insulin that administered before the start of a meal/snack. Pre-bolusing insulin allows the insulin to start working in the body so that the food and insulin meet at the same time. This helps avoid spikes in blood glucose and is a best practice. Most individuals pre-bolus 15-20 minutes before eating (assuming the blood glucose is within a target range). The timing varies by brands of insulin, per person and blood glucose level at time of bolus (higher blood glucose levels typically delay how fast insulin starts working).
Post-bolusing – rapid acting insulin that administered at the end of a meal/snack. The amount of carbohydrates consumed during the meal is calculated and the necessary amount of insulin is bloused. This method is helpful with toddlers due to not knowing how many carbohydrates will be consumed during the meal/snack.
Pre- and Post-bolusing – rapid acting insulin that is administered ½ before the meal and the other ½ at the end of the meal. This method is helpful with toddlers due to not knowing how many carbohydrates will actually be consumed during the meal/snack. Pre-bolus insulin before the meal to cover the carbohydrates that you are certain will be eaten and then complete a final carbohydrate count at the end of the meal to determine remaining bolus that is needed.