Have any of you been using a pump and then decided to go back to MDI?
I can not answer your question since I have always used MDI. I tried a catheter once and this experience was not very convincing. In my opinion it is very important that every pumper can switch seamlessly from pump to MDI and back. This does prepare for emergencies and more importantly the experience allows you to compare them.
Pumps and MDI have a potential space to explore. With modern basal insulins the potential of MDI is to some degree comparable to that of pumps. There are individual factors that can only be addressed with a pump. For these patients there is no alternative to pumping. However this is only true for a minority in the group of pumpers.
What remains is a higher flexiblity with the TBR feature, specific pumping programs like the extended release, very small dosages and digital logging. For that value you will have to rely on a permanent catheter that can be plagued with absorption, healing and acceptance issues. On top of that the costs of pumping are usually twice as high as on MDI. With MDI your basal coverage will be usually very good - at least with two shots of Levemir per day. This peace of mind can compensate for some of the flexility you will have to give up. New Pens like the NovoPen Echo offer 1/2 unit dosages and a memory function for the last injection. My project Glucosurfer tries to give back some of the pump features you will miss on MDI: IOB, dosage calculation, logging, good analysis and sharing with the community. My project stands for many more approaches in the web trying to improve MDI management.
I switch between the two regularly. I prefer MDI when at home - not having anything stuck to me, and two shots of Levemir give me near-perfect basal rates. I also use a Novopen Echo because of the 1/2 unit precision and memory function. When I travel, I use my Omnipod due to the convenience and discretion it provides, and also because I can easily change my basal rates. I do quite a bit of international business travel and find it can dramatically impact my basal needs.
I tried MDI last summer. We went to Maui and I figured I would want to swim, surf, play in waterfalls, etc.
I tried it at home for 3 days with the CGM in, flattened my basal in the pump to 0% and just pumped boluses figuring that would help smooth out the transition. It worked great! The trip was another matter. I was hugely jet lagged, it seemed like I had double DP going as I had a middle of the night spike and then another spike at dawn. Lots of ups and then corrections, it was a lot of work and I was very relieved to go back to the pump and CGM to relax the last couple of days.
I only used the pump for a week...which some people would be like "that's too soon!" but found out it wasn't for me at all despite getting hyped up for it and thinking it'd be awesome. There was a combination of factors there but mostly the infusion sets giving me immense issues that I don't think waiting more would help me on (like I'd get rashes from them, even the metal ones, and the plastic ones would bend and fail every time no matter what I did) . I found my blood sugar control also suffered when I used the pump and it just wasn't for me. MDI has me in great control. I don't suffer from a lot of problems that people with pumps say MDI caused them , sometimes I think my lantus dose is a bit off no matter what I do, but I still have more control with MDI and found it to be best for me. It's also really nice to sleep without something attached to me, shower without an infusions set to worry about, get dressed without ripping it off, go around doors without getting an infusion set ripped off. It's just inject and done and rarely do I worry about it. In the end , I'm also saving a TON of money which is great when I'm trying to start being more of an adult and more responsible for myself.
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