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In veterinary medicine a bolus is a large time-release tablet that stays in the rumen of cattle, goats, and sheep. It can also refer to a dose of liquid injected subcutaneously with a hypodermic needle, such as saline solution administered either to counteract dehydration or especially to mitigate kidney failure, a common ailment in domestic cats.
Basal insulin is provided as a once or twice daily injection of dose of a long-acting insulin. In an MDI regimen, long-acting insulins are preferred for basal use. An older insulin used for this purpose is ultralente, and beef ultralente in particular was considered for decades to be the gold standard of basal insulin.
Advantages to the person are better control over background or basal insulin dosage, bolus doses calculated to fractions of a unit, and calculators in the pump that may help with determining bolus infusion dosages. The limitations are cost, the potential for hypoglycemic and hyperglycemic episodes, catheter problems, and no "closed loop" means ...
Thus, the basal rate could theoretically be set based on an averaged bolus insulin intake of several days. Averaging the total bolus, and then dividing this number by 36 would then give the required hourly basal rate intake for any individual with a 60:40 ratio established.
The extended bolus is also useful for those with slow digestion (such as with gastroparesis or coeliac disease). A combination bolus/multiwave bolus is the combination of a standard bolus spike with an extended bolus square wave. This shape provides a large dose of insulin up front, and then also extends the tail of the insulin action.
Participants in this trial had an average HbA1c of 8.3–8.4%, and 49–50% were on a regimen consisting of basal-bolus insulin plus oral antidiabetic medications. After 52 weeks, insulin degludec was found to be noninferior to insulin glargine, providing a similar HbA1c lowering effect (−1.10 vs. −1.18%).
Bolus An amount of something given in one 'lump.' A meal is a food bolus, continuous snacking for an afternoon is not. In diabetes, bolus is an extra amount of insulin given in a single dose to cover an expected rise in blood glucose (sugar), such as the rise that occurs after eating. Borderline Diabetes A term no longer used.
Any change in basal or bolus is patient-driven by programming the pump using the Bolus Wizard. The latest model pumps are the MiniMed Paradigm 522 and 722, which differ in reservoir size, 176 versus 300 units, respectively. In 2007 the FDA approved a pediatric model for patients 7 to 17 years old. [6]