If you have diabetes, you know that dealing with the continuous flow of new information on insulin, blood glucose testing, and diet restrictions can be very overwhelming at times.

If you’ve recently been diagnosed, or if you’re an experienced user who is unhappy with your current insulin treatment, then perhaps it’s time to ask your endocrinologist about basal insulin.

Here are some questions you might want to consider asking during your next appointment.

What is basal insulin and how is it used?

According to the American Diabetes Association (ADA), basal means “background,” which makes sense since the job of basal insulin is to work behind the scenes during fasting or sleeping hours.

Basal insulin comes in two forms: intermediate-acting and long-acting. Both are designed to keep blood glucose levels normal while fasting but differ according to dosage and duration of action.

Long-acting insulin, also known as insulin glargine (Lantus) and insulin detemir (Levemir), is taken once or twice a day, usually at dinner or bedtime, and lasts up to 24 hours.

Intermediate-acting insulin, also called NPH (Humulin and Novolin), is used once or twice daily and lasts for 8 to 12 hours.

Will adding basal insulin to my diabetes treatment plan be right for me?

Since every person is different, only your physician can tell you what type of insulin therapy is best suited for your needs.

Before recommending basal insulin, they’ll take into account your body size, diet, activity level, hormone levels, most recent A1C test results, and whether or not your pancreas is still producing insulin on its own.

Will my basal insulin dose change? Why?

Your physician might consider changing your basal insulin dosage for several reasons.

If you start to show higher blood glucose numbers during the day, then it’s normal for your basal insulin dose to be increased. If your numbers tend to go lower throughout the day, then your dose may need to be decreased.

If there’s a substantial rise in your activity level, then a reduction in your basal insulin is almost always needed.

If you’re anxious or stressed, your physician will more than likely decide to alter your dosing requirements. Stress can decrease insulin sensitivity, which means the insulin doesn’t work as well in your body. You may need more insulin to keep your blood sugar in check.

If you’re sick, you’ll likely need extra basal insulin to help lower high blood glucose numbers caused by infection. According to the ADA, illness creates an enormous amount of physical stress on the body.

Additionally, the Mayo Clinic cites that menstruation can impact a woman’s blood glucose levels. This is because changes in estrogen and progesterone can cause a temporary resistance to insulin. This might require an adjustment in dosage needs, but this can also change from month to month depending on the menstrual cycle. Blood glucose levels should be checked more frequently during menstruation and any changes should be reported to a physician.

Are there any side effects with basal insulin?

As with most types of insulin, low blood sugar or hypoglycemia, is the most common side effect associated with basal insulin usage. If you begin to show too many low blood sugar incidents throughout the day, your dosage will need to be changed.

Some other possible complications of basal insulin include weight gain, allergic reactions, and peripheral edema. By consulting with your physician, you can gather more information on these side effects and whether or not you may be at risk.

When it comes to basal insulin and other types of insulin therapy, your endocrinologist and diabetes educator can help guide you toward the treatment that is best suited for your needs and lifestyle.