Basal Insulin:
Basal insulin is an intermediate and long-acting insulin that is recommended for people with type 1 diabetes. It is sometimes also recommended for people with type 2 diabetes and gestational diabetes. Those with type 1 diabetes use basal insulin along with rapid-acting insulin. These insulins are generally given in the form of injections or in disposable insulin pens. Basal insulins are injected under the skin and their release into the body is slow and steady. The main purpose of prescribing basal insulin is to ensure the maintenance of blood glucose levels throughout the day. Generally, the dosage of a basal insulin is twice a day. Referred to as a background insulin, basal insulin is taken in order to reduce high blood sugar levels. This is useful during periods of sleep and fasting. Since the liver secretes glucose into the bloodstream during the fasting periods, basal insulin helps in controlling the blood sugar levels during these periods. The liver secretes glucose in order to compensate for the lack of carbohydrates. If there is still a deficit of carbohydrates in the body, it starts using the proteins and fats and converts it into glucose. This process is called Gluconeogenesis (See: Gluconeogenesis). In another process where the adrenal glands release epinephrine, there is production of glucagon from the liver. All these processes tend to increase the blood sugar levels and thus needs a management apart from the short-acting bolus insulin shots given before the consumption of food. So, basal insulin is given. It helps reduce the levels of HbA1c and in general one dose of basal insulin lasts for 18 to 24 hours. Basal insulin consists of two types including long-acting insulin, and intermediate-acting insulin. Long-acting insulin acts for 24 hours. The number of injections (one or two), and the number of units prescribed is as per the intensity of the diabetes. Though long-acting insulin has no peak action (minimal peak effect), some might notice a peak action after six to eight hours after administering the dosage. The onset action starts from one to one and a half hour after the administration of the injection. Intermediate-acting insulin lasts from four to 12 hours and its onset action starts after one hour of the administration of the injection. It shows a peak action after four to six hours; however, the release is continuous and gradual. The dosage, the timings of the injections, and the combination of the basal and bolus therapy differs from person to person. It is best determined by the healthcare providers in order to avoid unwanted hypoglycemic incidents.
