Understanding Basal Insulin

Basal insulin (not to be confused with basil you cook with!) is a common medical term used to describe long-acting insulin.

What is basal insulin?

Long-acting insulin is insulin which is typically taken once a day (although some folks end up taking it twice a day) and lasts up to 24 hours. With some types, it may last beyond 24 hours.

The term basal insulin can also be used when referring to HOW insulin is used (rather than WHAT type of insulin is used). For example, in an insulin pump, insulin is released continuously into the body. While the insulin in the pump is not long-acting insulin, that continuous release of insulin is called a “basal rate.”

What does basal insulin do for our bodies?

Basal insulin is meant to replace the body’s natural insulin production that happens throughout the entire day and night. It keeps blood sugars stable in-between meals and in the overnight hours.

This type of insulin is usually the first type those with type 2 diabetes start taking. The exception to this is if your blood sugars were very high at the time of diagnosis and you needed more than one type of insulin.

Basal insulin as part of a diabetes management plan

Basal insulin can be taken with other diabetes medications to create a personalized plan that meets your body’s needs. Finally, insulin is unique in that each person’s dose is going to be different - you may take 60 units, while someone else needs 10 units. It’s not an indicator of whether one person’s diabetes is better or worse, it’s truly just replacing whatever YOUR body needs.

Call-outs about basal insulin

A couple of things to know:

Your dosage may change after the 1st dose

The first dose you are prescribed is not intended to be the dose you stay on. It’s an introductory dose based on guidelines and/or your weight. If you still see higher blood sugars after you start basal insulin, it doesn’t mean that this medication won’t work for you. It just means you need your doses adjusted to what your body needs.  Contact your medical team to help you. This holds true if you’re experiencing low blood sugars as well.

There is a "max" dose

There is somewhat of a “max” dose when you use basal insulin alone (without other types of insulin). The benefit of lowering your blood sugars caps out at a certain level. Thus, if doses continue to get pushed higher and higher, your risk of low blood sugars and weight gain increase, while you only see minimal changes in your blood sugars. This is because long-acting insulin cannot replace all your insulin needs. At a certain point, your body also needs the addition of rapid-acting insulin (which is taken with meals), along with long-acting insulin, to stabilize your blood sugars.

Finally, a word of encouragement. Needing or using insulin is NOT a sign of failure. Insulin is a powerful, vital tool to help you manage diabetes. Many have used insulin successfully for years to achieve great diabetes health.

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