At the heart of managing diabetes is the need to balance blood glucose levels and insulin. When it comes to insulin therapy in the hospital, there are two common approaches: basal/bolus and sliding scale insulin.
Basal/Bolus Insulin
Basal/bolus insulin is a method of giving insulin that is more similar to the natural release of insulin in the body. Basal insulin is given as a long-acting injection to provide a steady, background insulin level throughout the day. Bolus insulin, on the other hand, is a short-acting insulin given before meals to help control the rapid rise in blood sugar that occurs after eating.
Research has shown that basal/bolus insulin therapy is more effective at controlling blood sugar levels than sliding scale insulin. It may also lead to fewer episodes of hypoglycemia, or low blood sugar levels. This method of insulin therapy is generally preferred for patients who are able to eat regular meals and have a predictable schedule.
Sliding Scale Insulin
Sliding scale insulin is a method of insulin therapy that is based on a patient’s current blood glucose level. The dose of insulin is adjusted based on a sliding scale, with higher doses given for higher blood sugar levels. This method of insulin therapy does not take into account the amount of food a person is eating, which can lead to erratic blood sugar levels. It also does not provide a steady insulin level throughout the day, which can make it harder to control blood sugar levels.
Despite its disadvantages, sliding scale insulin is still a commonly used method of insulin therapy in the hospital. It may be preferred for patients who are unable to eat regular meals or have unpredictable schedules. However, research has shown that basal/bolus insulin therapy is generally more effective at controlling blood sugar levels and reducing the risk of hypoglycemia.
Choosing the Right Insulin Therapy
When it comes to choosing between basal/bolus insulin and sliding scale insulin therapy, there are a number of factors to consider. These may include the patient’s ability to eat regular meals, their schedule, and their current blood sugar levels. It is also important to consider the potential risks and benefits of each method of insulin therapy, as well as the potential for drug interactions and side effects.
Ultimately, the choice of insulin therapy will depend on the individual patient and their unique needs. By working closely with a healthcare team, patients with diabetes can receive the most effective treatment for their condition and achieve better outcomes over time.
