Answered 9/9/2014 by Samuel Grossman, BS Pharm, Pharm.D, CDE
There are 2 kinds of insulin products: Long-acting or basal insulin and short acting or bolus insulin. Basal insulin products can be given without regard to meals and these insulin products control blood sugar before meals. Bolus insulin products have to be given within 15 minutes of the meal (30 minutes before meals for regular insulin) and these insulin products control blood sugar after the meals. Insulin is usually initiated when oral medications are not able to improve glucose levels. Initially, basal insulin is prescribed and the dose is titrated to achieve optimal glucose levels before breakfast. When glucose after the meal is not controlled with oral medications, bolus insulin is initiated to help control glucose levels after meals. Bolus and basal insulin work together to ensure that glucose levels stay controlled throughout the day.