MDI is the term (multiple daily injections) has many advantages.
PUMP
Pumping is far more expensive.
Pumping requires obscene “backup” supplies, if something needs to be changed out/goes wrong with yours (eg Skin prep wipes, tubing, tape, infusion sets, a large caliber syringe to prep the line, saline, large CC needle, an infusion set gun, extra batteries, etc.). MDI have none of those save wprst case a vial and syringe (insulin pens reduce that MDI worst case by half…)
Pumping has the risk of causing skin infection at the infusion sites a problem which does not exist with MDI
Taping down the infusion set causes meaningful irrition and tenderness
Mechanical delivery errors by a pump cause severe DKA
Mechanical delibery errors care nothing for textbook correct proceedure by their users, requiring a repetition of the extensive proceedure a second, or third time for no known reason.
Insusion sets for a pump require meaningful taping, skin prep in order to stay attached with many
Infusion sets require placement in body locations which will not get pulled, tugged, amd meaningfully irritated if too close to waistlines, or clothing, underwear of any kind
A PUMP being an external medical device will be caught on things, pulled off, moved and consequently cause the wearer problems, discomfort, pain, embarrassment.
A pump does not work well with heavy physical contact activities. It gets in the way or flys off.
A pump makes some extremely self conscious; where does it get put on a bathing suit, a formal dress, lingerie, etc.
One must love the beeps, meaningful alarms and noises a pump will cause.
Some pumps cannot get wet, requiring detachment from them to shower, bathe, swin
The pump requires severe tweaking, to achieve the “control” it is marketed and its PR they are assured to provide its users. There is NO GUARANTEE said control will ever occur.
There is a SEVERE financial incentive by doctors and CDE’s to get us on a pump. They get paid incentives, bonuses for connecting us to them. MDI does not have that incentive
A pump is never a magic wand which will make diabetic problems simply disapear. A pump requires insane hard work, and even more monitering to make them perform as promised,.
The identical problems which exist with MDI still exist with any pump/ There is nothing a pump removes if for no other reason you & I are still counting the carbs, figuring out when we will be eating, after our workout, how much bolus to use. Until a pump is entirely beyond our interference (ie closed loop) and I cannot interfere, make stupid mistakes, a pump provides nothing special.
Pumps offer an emotional crutch, or a false security for many. It requires extensive monitering
Pro’s
A pump provides insulin in microdoses.
It provides an emotional illusion that "control"is easy/very possible.
Pumps have a formula for delivery which covers high fat foods; chinese, pizza well
MDI
You inject multiple times a day, typically every day of your life
Numerically more injections are required than the number of infusion sets required over the same period.
The more insulin injected at a single time the greater the chance it will be excessive amount over a longer period of time
MDI requires long and short acting insulin, to prevent a gap in coverage while sleeping
Longer acting insulin, can still have a peak to it because of its duration. Therefore longer acting insulin can cause problems which short acting does not solely because it is shorter acting. Whatever shorter acting insulin does it is out of the body in 3-4 hours.
You could not pay me to use the current pumps again, for any reason! Cute marketing, astounding PR, but little substance… IMHE…