A Basal Insulin Primer

Learn why people with Type 1 diabetes need this long-acting insulin, and treatment options.



Integrated Diabetes Services (IDS) provides detailed advice and coaching on diabetes management from certified diabetes educators and dieticians. Insulin Nation hosts a regular Q&A column from IDS that answers questions submitted from the Type 1 diabetes community.

Q: Why does a person require basal insulin, even when they are not eating?

A: Excellent question! A healthy, functioning pancreas secretes small amounts of insulin every few minutes to balance the glucose being secreted by the liver. The liver produces glucose all the time to supply vital organs with a constant source of energy. Because the liver’s glucose production is influenced by various hormones, and some of those hormones are present in different amounts at different times of the day, basal insulin requirements also tend to vary by time of day. The goal of Type 1 diabetes management is to match the pancreas’ function as closely as possible.

There are several options for delivering basal insulin, including:

-Glargine (Lantus) and detemir (Levemir), taken once or twice daily, provide a relatively flat level of basal insulin in the bloodstream around-the-clock.
-NPH insulin (including Humulin N and Novolin N) taken two or three times daily also provides basal insulin, albeit with significant peaks and valleys.
-Insulin pumps deliver basal insulin in tiny pulses of rapid-acting insulin every few minutes. Because pumps allow us to vary the amount of basal insulin by time of day, studies have shown they give the best opportunity to mimic a healthy pancreas.

Have a Question? Insulin-Quiring Minds is a free service of the clinical team at Integrated Diabetes Services LLC. Submit your questions to jennifer@integrateddiabetes.com. All questions will be answered, and yours may be chosen to appear in Insulin Nation.

Integrated Diabetes Services provides one-on-one education and glucose regulation for people who use insulin. Diabetes “coaching” services are available in-person and remotely via phone and online for children and adults. Integrated Diabetes Services offers specialized services for insulin pump and continuous glucose monitor users, athletes, pregnancy & Type 1 diabetes, and those with Type 2 diabetes who require insulin. For more information, call 1-610-642-6055, go to integrateddiabetes.com or write info@integrateddiabetes.com

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Jennifer Smith holds a Bachelor’s Degree in Human Nutrition and Biology from the University of Wisconsin. She is a registered and licensed dietitian, certified diabetes educator, and certified trainer on most makes/models of insulin pumps and continuous glucose monitoring systems. She has lived with Type 1 diabetes since she was a child,and thus has first-hand knowledge of the day-to-day events that affect diabetes management.