We had an awesome conversation this week about the pros and cons of using multiple daily injections (MDIs) verse an insulin pump. Have a listen by clicking the image above, and know, the main takeaway is to explore and try out all of the options before you land on what works best for you!

My shortlist of why I am on MDIs for now…

MDIs Pros:

  • Less anxiety on absorption and getting a good site every 5’ish days (this is the core reason I don’t use a pump right now/for the last 3 years).
  • What I inject, I more than likely know I absorb. Many times on the pump, my absorption overnight was poor and I’d wake up very high.
  • I don’t have to worry about my kids ripping off my site, or bumping it while we play, and/or while exercising
  • Less hourly strain to micromanage my basal rate and perfect it so I don’t go low or high at X time tomorrow.
  • I can rotate sites more readily and daily.
  • Lower risk of not getting background insulin due to a pump occultation (this has happened far too often on my pumps: Medtronic and Omnipod)
  • I am able to have not only optimal A1C% levels (6.0 and below in the last 3 years), but I have a better time in range (TIR) or standard deviation (SD) as I don’t have fluke highs from site changes, etc.
  • There are various background/long-acting insulin options and I have fallen in love with Tresiba. It has a better 24-hour life (much more forgiving) and no peaks/spikes.
  • Not using technology and having to order supplies for a pump allows for a more economical option for MDIs.
MDIs Cons:
  • Not able to tweak hourly basal needs (although I split my Tresiba into 2, 12-hour doses)
  • Not as easy to react to “sick-days,”
  • I have to babysit meals that are high-fat and high-carb, where the pump has specialized bolus features.
  • I have to have a consistent soft routine with my meals, especially dinner to have ideal overnight readings.
  • Not able to turn “off” background insulin as one could do with an insulin pump when blood sugar is dropping too quickly.
Will I be on MDIs for the long haul? I am not sure, but I don’t think so. But for right now, for the chapter and season of life, I am in, MDIs are great. I couldn’t have done MDIs in college, and I did both the pump and MDIs in pregnancy and even with the anxiety of absorption, the pump made pregnancy easier.
We are blessed with a variety of tools, medications, and technologies to help us manage type 1 diabetes, and we can’t sell ourselves short and be content with what we are using, and we need to be aware of our options and what can give us the highest quality of life.