Basal-Bolus Insulin Therapy 

Someone with diabetes may need help controlling blood sugar in 2 ways:

  • Insulin therapy that controls blood sugar between meals and during sleep is called long-acting or basal insulin
  • Insulin therapy that controls blood sugar when you eat is called fast-acting or bolus insulin. On this site, we often refer to it as mealtime insulin. NovoLog® is a bolus insulin (also known as a fast-acting or mealtime insulin)


Basal-bolus insulin therapy uses 2 types of insulin to closely mimic the body’s normal insulin release.

In the body of a person without diabetes, insulin is released:

  • In a steady “basal” amount, day and night, to help control blood sugar between meals and while you sleep
  • In “bolus” bursts to help control blood sugar spikes that happen when you eat 


Basal-bolus insulin therapy (also called intensive insulin therapy) uses long-acting (basal) and mealtime (bolus) insulin together to closely mimic the body’s normal insulin pattern throughout the day.

The basal-bolus principle

Basal-bolus insulin therapy is recommended:

  • For people with type 1 diabetes 
  • For people with type 2 diabetes who need more blood sugar control than basal insulin alone can provide 

If you have type 2 diabetes, you may already be taking a long-acting, or basal, insulin at night or in the morning (sometimes both), to help control blood sugar between meals and when you sleep. However, if your blood sugar is still too high, your diabetes care team may add a bolus insulin (such as NovoLog®) to help control blood sugar spikes that happen when you eat. 

What is basal-bolus therapy? (4:55 min.)

A fast-acting insulin analog like NovoLog® can be taken along with a long-acting insulin for additional blood sugar control.

If your health care provider tells you that you need to add a mealtime, or bolus, insulin to your care plan, this does not mean that you have failed to take care of your diabetes. Even if you've been doing everything you can to manage your diabetes, over time, you may find you need more medicine to help control your blood sugar. This doesn't mean that you haven't been doing everything right. What happens is, diabetes changes over time. So it’s important to stay on top of your numbers to make sure this isn’t happening. If it does, your diabetes care plan, including your medicines, may need to be changed to help you stay in control. 


Your basal-bolus insulin therapy care plan

Your basal-bolus therapy care plan will include:

  • Taking your long-acting basal insulin dose as directed by your health care provider
  • Taking your fast-acting bolus insulin dose of NovoLog® at 1 or more meals a day (up to 3 times daily) 
  • Adjusting your dose based upon food and physical activity 


This combination closely mimics the body's normal insulin pattern throughout the day and has been shown to help people with diabetes lower their A1C levels. 


It will also be important to:

  • Monitor your blood sugar levels often 
  • Follow your meal and exercise plans closely 
  • Communicate with your diabetes care team regularly 


Basal-bolus therapy is recommended for appropriate patients by the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE).

For more information on basal-bolus insulin therapy, talk with your diabetes care team. Together, you can decide if it is right for you. For help talking to your doctor, try using our Doctor Discussion Guide.



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