Bolus Insulin

Generally speaking, whenever someone with type one diabetes eats anything with carbohydrates, they need insulin to cover those carbohydrates so their blood sugar does not shoot to the moon. This can be accomplished a few ways: a bolus by injection, a bolus by insulin pump, or in more rare instances, the carbohydrates are covered by longer-acting insulin that is already “on board” and waiting to work.
When you have diabetes, food is a very interesting thing. As soon as you are diagnosed with the condition, your relationship with food automatically is changing. Some foods will make your blood sugar go high no matter what you do, some will make you drop even if you count them as less than you should. Here is where we will start talking about some of the more complex aspects of diabetes life.
Most people with type 1 diabetes will have an insulin to carbohydrate ratio that their diabetes doctors have helped them figure out. This ratio tells us how much insulin you need for a certain number of carbohydrates. For example, one can have a ratio of 1 unit of insulin to cover 15 grams of carbohydrate. To put it in diabetes terms, their I:C ratio is 1:15.
The other main type of blousing for someone with type one diabetes is a correction bolus. This is used when the blood sugar is higher than you would like it to be. With correction boluses, there is something called an insulin sensitivity factor, or ISF. This ratio will tell you how much insulin will LOWER the blood sugar a certain amount. For example, you can have an ISF where 1 unit of insulin will lower the blood sugar 100 points. This would be an ISF of 1:100.
You can have a meal / snack bolus alone, you can subtract some from the bolus because of a slightly lower than desired blood sugar or for upcoming activity that would be expected to drop the blood sugar. Correction boluses can also be given alone. Sometimes you even have to get a bit crazy and give a bolus that is for a meal / snack AND correcting a high blood sugar at the same time!


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