Understanding flexible dosing of insulin 

Flexible bolusing, sometimes called flexible dosing or multiple daily injections (MDI), is designed to mimic the body’s normal production of insulin. It requires you to inject a background amount of insulin daily and an extra dose of rapid acting insulin (known as an insulin bolus) with each meal. This means people on MDI will have a minimum of 4 injections each day.

Basal insulin (e.g. glargine or Levemir®) is background long lasting insulin, given at a similar times every day. It ensures you have insulin in your body at all times. 

Bolus insulin (e.g. NovoRapid® or Humalog®) is rapid acting insulin given before each meal that allows you to use the carbohydrate you eat for energy. This dose should be matched to the amount of carbohydrate you eat.

“Flexible” means you can inject different amounts of insulin depending on:

1. how much you are planning to eat, and
2. what your pre-meal blood glucose level (BGL) is.

Adjusting your insulin doses to match your food intake, and correct any BGLs that are above target, will help you keep your BGLs in target range.

It also means you can be flexible with the timing of your meals. Unlike twice-daily insulin regimens, your meals do not have to be eaten at strictly the same time.  

Flexible bolusing can also help you manage sport, illness and times of stress more easily.

If you are adjusting insulin based on how much you are planning it eat, it is important to have a good understanding of carbohydrate counting. Contact your dietitian if you need help with this. 

If you are interested in trying flexible dosing/bolusing, discuss this with your diabetes doctor at your next clinic appointment. 

See below information to help with understanding more about how you can use flexible dosing as well as how the dosing settings work: