Basal/bolus balance describes how your total daily insulin dose (TDD) is divided between basal insulin (background insulin from long-acting injections or pump basal rates) and bolus insulin (meal and correction doses). In clinical studies, basal insulin typically accounts for 48%-54% of TDD. However, the ideal split varies with carbohydrate intake, insulin sensitivity, age, weight, and whether you still make some of your own insulin—especially in the first years after diagnosis.
How Much Do You Need?
| 10.8 Common Basal Percentages of TDD | |
|---|---|
| 40-44% | Kids and adults who are sensitive to insulin, physically fit, on a high-carb diet, or have residual insulin production in the first 5 years after diagnosis. |
| 45-60% | Most people |
| 60% or more | Adults or teens on a low-carb diet or who often miss carb boluses. |
Although there are no perfect answers, almost all Type 1s and most people with Type 2 on insulin find that their control is best when their long-acting insulin (Lente, NPH, Ultralente, or the basal rate on a pump) comprises 55% to 60% of their total daily insulin dose. This level allows you to skip meals and still maintain relatively stable blood glucose.
How Do I Tell?
| H or R | L/N/UL | |
|---|---|---|
| Breakfast | ___ units | ___ units |
| Lunch | ___ units | ___ units |
| Dinner | ___ units | ___ units |
| Bedtime | ___ units | ___ units |
| Subtotal | ___ units | ___ units = A |
| TDD | ___ units = B | |
Then divide your total long-acting insulin (answer A) by your TDD (answer B):
A / B = ____% as your Basal/Bolus Balance
Critical question: How close is your own TDD to 55% to 60%?
Last Updated on December 31, 2025