Thanks for that detailed explanation Holger. Now that sounds like a Good reason to use Levemir. I’ve been doing pretty Good with Lantus and have raised/lowered to suit my situations better. I usually take 19-22 units total daily split. But there is always room for improvement, sometimes with the help of different meds.
Good Luck Amanda and thanks fo the topic. 
If I understood that correctly you have split your Lantus dosage. As a result you are taking two shots per day. I have heard that this leads to a good basal coverage too. Lantus will most likely act longer than Levemir if applied in the same dosage. Thus the two shots of Lantus stack on each other. I have a little problem with that: let us assume you inject 10 units every 12 hours. If every dosage is active for 16 hours you will have times where the dosages overlap or stack. I would fear that this would lead to chaos but many users have good results with splitting Lantus so it might be that the stacking effect is very small. In my last diabetes training I had one guy who was told to split his 48 units of lantus (24 in the morning and 24 in the afternoon). Well, he did not listen carefully and injected 48 units in the morning and afternoon. The amazing thing was that he had superb numbers and the team encouraged him to continue this treatment. Again a case of: do what works best for you.
Sorry Holger, I wasn’t aware of your reply.
In 2006, I tried the 50/50 with Bad results. So then I gradually turned my dosages to 60/40. My basal testing had shown this to be the right dosage and split for me @ 12 hours apart.
Wow! on the 48 units twice a day. That’s a lot of Lantus. Great that it worked for him though. Diabetics are amazing!! 
Thanks! I appreciate your input.
I decided for the summer I would return to shots. I was using the OmniPod. I lasted exactly one month back on shots. While I have a better understanding of how things work, I never realized how much I depended on my pump to “take care” of me. I do not mind shots, but having to remember to take the Lantus once a day, then Novolog before every meal got to be too much for me. I always was good testing, so that was not the issue. Money is tight for me too, so I know where you are coming from. Good luck!
I’m 35 years into this crap and never had much interest in the pump. Back about a decade ago when I went back to my endo to learn the carb count thing and MDI he suggested to look into the pump as an alternative. I didn’t like the idea of being connected. On top of that I heard about some the other problems associated with them along with the additional cost factor. Back then I had insurance where I don’t now. The shots in all honesty are the least of the problems with this disease. Sometimes I take 8 to 10 a day and don’t think about it much. I think one of the reasons they push the pumps on the newer generation cause its more profitable. Let’s hope the Smart Insulin trials go well and then you can spare your fingers from destruction as well.
I haven’t tried pumping myself - I’m in the process of considering it - but have lots of experience with MDI so will add my two cents.
First thing to consider is how constant your basal rate on the pump is currently? If your basal rate varies a lot during the day from one hour to the next then you are unlikely to be very happy with MDI.
But if your basal rate is almost constant, then I have found two injections of Lantus, 12 hours apart, works very well for me. A single injection of Lantus definitely did not last a full 24 hours in my case. But equal injections (one on waking, the other 12 hours later with dinner) works great. In my case I do not need to be overly concerned with exact timing - as long as I’m within a couple hours for either basal injection I seem to do OK in achieving a pretty constant basal.
Bolus amounts and corrections won’t be much different than they were on the pump so those should be pretty natural.
BTW, if you do do this, please post your results - A1c’s before and after. I’m very interested in whether you will see a difference in control.
Good luck!
I have been on the pump for 2 years and would dread the thought of going back to the needles. Personally, I would do side work or get another job to support my supplies…this is that important to me.
Money isn’t as important as your health, and if your A1c’s are better with the pump; stick with it and stiff a bill if you have to.
Oh - I wish I’d seen you post earlier! I’ve been doing this on my own - switching back to MDI - after pumping. I started back in April - have been blogging about it as I tumbled along. Because I’d been MDI for 40 years prior to pumping - for me it wasn’t that difficult to do. I did find tho’ that being on the pump like others have said here has made me understand how my insulin works much better then I did before. I think I was just very lucky when I was MDI with an A1C of 7% that I was “winging it” correctly. My issues with MDI was having lows over night and in the morning - great for that morning commute to work on the Metro! Stumble, mumble.
Since going back on MDI - which I only plan to do until my next A1C - I’m finding it much better with my BG’s - tho’ switching from Lantus to Levemir created a few probs (e.g. I’m slightly allergic to Levemir - insulin bump that disappears after 24-36 hours - and itchiness). Other then that, I’m okay. I’m actually not sure about going back to my pump - Salvador Dali - but I figure since I’m still paying for him - I should use him until he’s bit the dust - but I do enjoy the freedom of not being hooked up - except I find with MDI - you do have to “think” abit more about your diabetes then I did with the pump.
I’ll check the rest of the posts here - I’m not supposed to be online tonight - packing up for Canada Day celebrations - but I just had to have my fix of Tudiabetes before I switch off my PC for the night.
Take care!
Anna aka FatCatAnna \^^// - The Roller Coaster Ride of Diabetes - Whoo! Whoo!
Hi Anna,
I am loving my “vacation” from the pump; I love the freedom (are diabetics ever truly free? I think not). You are right, you have to “think” SOOO much more about it, which is exactly what I needed. I became a bit lazy with the pump, and would let things slide. Now that I’m on Levemir and Novolog, I am super conscientious about my BG all day long and am super careful about carbs and eating. Turns out to be a good thing for me so far, been off the pump since February.
I am thinking about a pump vacation as well, but I always hated shots.
I feel I have more lows on the pump because of the constant fast acting insulin.
Let us know how things go as I always feel the grass is greener on the other side.
A1c’s before: 6.something
After: 5.4 for 2 years (no dieting)
Hi Amanda, all I will add is that if you want to stay on your pump, don’t let money be the reason you switch… I work in biotech and I can tell you first hand that companies are spending oodles of money in patient support programs and ultimately they will work really hard to keep you on their therapy during your hard times. Get in touch with your pump company and see if they will help. Also, you can apply for funding with NORD (national organization for rare disorders). They are a non-profit working to help people in your situation. Good luck to you girl!
To be clear, is “before” with the pump, and “after” with MDI, or visa versa? If not, then that is not the same question that I’m looking for an answer to. Assume there is a learning curve you master when you start on a pump (e.g. really getting to understand carb counting better). Then your improved A1c could be due to the pump itself, or to having mastered the learning curve, or a mix of both. The only way to know which, is to go back to MDI after being on the pump.
Have you gone back to MDI since you went through that learning curve - if so did your A1c go back to 6. something or did it stay in the 5’s?
Before is with Injections, After is with the Pump.
I really don’t understand how injections and the pump can really be compared:
You cannot perform a Dual Square Wave Bolus with injections.
You cannot experience the changes made in your Basal rate in a couple of hours with long term insulin injections (it usually takes around 72 hours).
There are no built in alerts with injections, or quick corrections…try injecting 2/10ths of a unit.
The metered amounts of insulin are much more calculated with the pump.
CGM can be connected to the pump.
As for Carb counting, there is no exact science, just familiarization with foods, their content, and their effects on your body. It is easier with the pump because it performs some of the math for you, but you still have the ability to makes changes to your doseage.
Hey all, I know it’s been a while since I posted. I’ve had an unnatural amount of change in the last month or so. Had to move quickly, switch to MDI, lost my job, broke up with my boyfriend of 7 years, had my phone shut off leaving me with only the computer as communication…oh, and my car broke down. there’s more to that story, but it just gets more depressing so I’ll spare you all the details.
As far as the MDI/pump switch goes, I’m not able to just take on a second job to manage my medical bills. I’m having a hard enough time getting ONE job. (not trying to come across rude, just a little jaded at this point. Please don’t let me offend any of you.) so I’m NOT in the “I’ll do whatever it takes to get my supplies” boat. I couldn’t afford them. I’m lucky I have a house to live in. That being said, I switched about a month ago. I had planned to use up the rest of my pump supplies before switching, but the ^ button started sticking when I went to bolus so I called minimed & had them send a replacement since it was still under warranty.
I decided that if I was gonna do it, that was as good a time as any, so I switched to MDI. It hasn’t been as hard as I expected. I’ve been managing pretty well. My only issue is that I sometimes forget to take my lantus in the evening if I’m occupied with something. I’ve had to tweak my doses, but I feel confident that if I don’t give myself too much slack that I’ll be able to achieve similar A1c (if not better, probably due to more focus -I think I came to rely on the pump to do too much for me-) results. My last A1c was 6.3 (last month, on pump) so in a few months I’ll be able to tell what kind of difference it’s made. Like I said, I’m still tweaking, but I’ve seen pretty stable results & don’t think it will change my control much. It’s just different & sometimes change/difference is scary. But I’m learning to embrace it. In all aspects of my life right now.
Thank you to everyone who responded. It’s great to know you’re all here.
I’d suggest if you’re diabetes management has been better on the pump (and multiple studies confirm that for many) then I wouldn’t rock the boat. Contact your pump company and explain your predicament. It is likely they have a way to continue working with you (like a reduced rate for supplies) and therefore not lose your business. But the real benefit is not having to resume the regimen of MDI. It does seem like maturity and discipline can afford a lot of benefit to diabetes management but in the long run – you’ll regret losing the flexibility and the control you had with the pump. I hope your pump company comes through!
I’m not saying pumping isn’t better - I’m only asking for evidence to support your opinion that it is. These two therapies are compared every day - and in case you didn’t know, there are members here who have stopped using their pumps because they don’t like them - for whatever reason. I’m not one of them - in fact I’m in the process of figuring out whether I should get a pump, CGM, or both. Which, again, is why I am looking for evidence.
In fact there is a science to carb counting - as is clear from the Walsh and Scheiner books which are devoted to teaching that science to insulin users. I’ve learned a lot since I started reading those books (and the Hanas “Type 1 Diabetes” book too which is great). I think its likely my A1c will increase substantially from the knowledge I’ve gained so far - while still using MDI. I’m trying to figure out whether pumping will improve it even more before I sign up for one - because you didn’t list the drawbacks of pumping which (for me) would only be outweighed if I could indeed improve my A1c even more.
Hmmm. Here’s an interesting graph that indicates (for a small number of T1’s) that if one’s starting A1c while on MDI is less than about 7.5, then the odds of improving A1c by switching from MDI to pumping are about the same as the odds of worsening A1c by switching from MDI to pumping. If one’s starting A1c is above 7.5, then pumping definitely gives a better A1c. LINK HERE
Feel sad to hear what u are going through. I was on shots for 17 of my 18 years of diabetes. When i say shots i am talking Humilin N and R (i did not have access to anything fancier than this). From my experience this what i can tell you. My A1c was < 7.0 for most part except on 2 occasions.
For shots to work, there has to be a lot of planning in meals and activities. I mean take meals at the same time every day and avoid sugars(essentially high GI foods) of any kind. This will help in avoiding momentary spikes in sugars. The reason is when u are on shots its going to be a “hit or miss”. I mean there is good chance that ur shots might be stacking up and this will lead unusual swing in your sugar level which is not good for your body. Take some green salads or a cup of milk in between your meals. especially one snack between your Break fast and lunch and the other between ur lunch and dinner.
Don’t stay up too late at night until necessary. the reason is shots do offer the flexibility to change the basal rate. Most T1 diabetics (after the first 5-6 years) tend to develop a different (lower) basal rate (especially from 12:00Am to 6:00AM period) than their usual basal rate. Always, Always please have a cup of milk before u go to bed or like 2-3 hours after ur dinner. This will further reduce swings in BS.
Remember lower A1c does not necessarily mean good control. A good control means not having wider swings in blood sugars. while on Shots there is a good chance for swings in BS to happen. I mean you can achieve an A1c of 6.2 even when ur BS are swinging from 60(fasting) to 280-320 (before ur dinner).
The rule is “meals and sleep at a fixed time every day and totally avoid any form of sugars.” If you follow this trust me u don’t have to test ur sugars more than twice a day!!!
i wish u good luck on ur job from the bottom of my heart.
I’m lucky on that side. I live in Norway and get all my pump stuff completly free and only pays 300 dollars for all my meds and and testing stuff! I would not change from pump what so ever because I think it would change my health for the worse and i find it much easier to use a pump because its more discret and more easy to bolus than having to take up to like 8 shots a day.