Gastroparesis and mdi

I’m new to this forum. It seems like a wonderful supportive community.

I have had type 1 for 35 years. I currently use a pump and cgm. I have recently been diagnosed with gastroparesis. I am having a lot of pump site issues lately and would really like a ‘pump break’ and to go back to mdi for a while. Not sure how easy it will be to manage this condition on injections though as the pump makes it so easy for temporary basals and dual wave bolus etc.
Does anyone with gastroparesis manage it ok on multiple daily injections ?
Any advice or experiences appreciated.

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I have, on a pump and MDI. I actually found MDI easier. I have now changed to Tresiba for my basal, and Afrezza for bolus and have a 5.8-6.0 A1C. Best change I ever made, and will never go back to the pump or MDI.


Gastroparesis is a very common complication of long-standing type 1 diabetes as a result of autonomic neuropathy, though for some reason there is very little discussion of it. I have it and use MDI, and I find that by having a higher than normal background dose I’m able to cover the delayed metabolism that comes with the condition. Some doctors recommend taking the meal-time, quick-acting insulin only at the end of meals rather than before the meals, though I have not found that useful. One of the silliest things gastroenterologists recommend is taking small doses of fast-acting insulin repeatedly during the day to cover the many small meals they recommend patients eat, but this really doesn’t work, since if the insulin is going to continue acting for 6 hours after each meal, it will start overlapping with the next meal’s dose and produce all sorts of confusion.

The drug, Domperidone, is perfect for controlling the disease, but some jurisdictions have banned it or severely restricted its use to short time-spans, which would make it useless for gastroparesis. The caution about Domperidone is based on its shortening of the Q-T interval of the heart beat, but the effect is in fact really minimal. It’s now unavailable in the United States, which forces patients needing it to go to Canada or the Caribbean to get it.

I have found that eating only pureed food controls the condition so well that I don’t need any Domperidone at all, and I used to have to take 60 mg a day.


Thanks for the replies. It is a very challenging condition. It’s good to know non pump users can manage the condition. I’m in Australia so domperidone is available on prescription and appears to be the drug of choice used to manage it.