The Pros / Cons of Insulin Pump / MDI

I posted this last month at - I’ve been on a pump holiday since April. For those of you who don’t follow my blog - I went off the pump to help other PWD’s that can’t afford a pump, but are having problems maintaining good BG’s with MDI control. I am lucky that I’d been MDI 40 years prior to going onto the pump, so I had abit of an idea of what I was doing. I decided to go back to my roots so to speak, after using Salvador Dali (the name of my Animas 2020) for a few years. I have learned alot with my insulin pump, and I think it has helped me understand how insulin/carbs/etc. all work. As of this point in time, I’m still tubeless, not sure about going back onto the pump, but feeling guilty because there are many diabetics out there that can’t afford this luxury, and here I have one sitting unused (and I’m still paying for it -that’s the other thing that bugs the heck out of me - it wasn’t cheap).

You can go to link at ( or simply open a new window and cut/paste the link - ) .

So, would you go back to MDI - even for a few weeks or ???

never ever for me. i needed more precise measurements than i could ever do with needles or pens. was always too low on MDI, no matter what i did… was hellish and hated hit :frowning:

The good thing now with MDI - is pen needles can give 1/2 unit doses of insulin - which works fine for me. I have to admit before these came along - it was a B#@! to not do the fight with low/highs. I was actually pretty surprised at how I’m doing with MDI as I expected to have same problems - which had caused me to go onto the pump in the first place. Main thing, I now know what to do if a) can’t afford to pump anymore; b) in an ER situation where I have nothing else to use.

@Virtue - how long ago was it that you were injecting?

Hi Anna. I’d really like more info on the pen needles that can give 1/2 doses of insulin. What brand of needles? Do they use a specific brand of pen? I use my MM522 part time, since I don’t have many pump sites. The rest of the time on MDI, I use Apidra from a vial and Levemir from a pen. Thanks.

Hi Alan, thanks. It would be very convenient to be able to measure a half dose of Levemir accurately.

Yes Trudy - having the 1/2 unit pen needle is heaven sent. I wish I could use Levemir insulin - but I have an allergic reaction to it - so had to go back to Lantus and that cheap plastic pen only doses in 1 units. I now have a spare NovoPen Junior - good for back up I guess. I may actually write to the manufacturer of Lantus and ask them if they’ve ever considered manufacturing a 1/2 unit pen needle. Another “add to my list” project to do when I get back from holidays :slight_smile:

I read your blog and the pro and cons of MDI vs pumping and I still prefer pumping. Like you I was on MDI for 40 years and have had over 10 years of pumping and pumping wins by miles.

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I have to say that MDI after pumping was both easier, and more frustrating. Easier because with a better understanding of how much insulin my body needs, adjusting doses is much simpler, but it’s frustrating because much of the flexibility you gain by pumping is lost.

Since I have trouble with pumping because of allergies, I often switch back and forth with MDI… so yeah, I basically have to rely on it sometimes, but I wish I didn’t have to. Take away issues with keeping infusion sets stuck, and the reactions I have to the insulin itself (swelling, itching, irritation) and pumping is far superior to a gazillion shots a day.

BTW, I have to ask, based on your blog post - how to do you come up with a $300 per month cost for pump supplies? Does that include sensors or tape or other stuff? I only spend about $125 a month for my pump supplies (one box of sets + cartridges), and I use flexifix tape when I need it, and I bought a $30 roll a year ago and haven’t used it up yet… so that doesn’t cost much.

Hi, on this subject, may I ask, exactly, how the pump helps keep you even, more so than careful MDI, or is it just easier to stay even using a pump? And if so, how… exactly? Can anyone spell it all out for me?

I started getting ready for setting my own basal rates (or trying to) a few weeks ago (documented a bit on a “blog” entry here), using my cgm and eating 0 to very, very few carbs, to “set” or figure out what my basal rates would be using a pump, using only Humalog for a few days, taking varying units per hour / half hour, testing like crazy and using the dex. So, I’ve been recommended to use a pump but still haven’t started it, so… can you guys let me know how much easier it is to stay even, and how you do it, exactly, using a pump? I don’t have an endo who I want to help me start so I guess I’m nervous-ish, and just would like to hear how you stay so even using a pump. But, the details if you would. Thanks!! :slight_smile:

Jojojovich what you need is a CDE or pump trainer to guide you thru the steps that are necessary to get you started for pumping.

@Sarah - I change my infusion sets every 2 days - which is recommended for the stainless steel infusion sets - probably due to the smaller needle - and possibility of getting clogged probably. With the plastic cannula I changed every 3 days - but I had reaction to the plastic - so went to the Comfort Set (Sure T’s) - with those I had/have no allergic reaction (when I pull out the infusion set you would not even know I had one in my skin - it’s that clean - with plastic cannula - you could tell where it was). So, with that in mind, my guesstimate for how much I was spending was $300 (give or take). I know for the pump program in the province of Ontario, they are allowed $200/month for supplies - and many that I have talked to go over and beyond that and pay out of their own pocket. Hope this helps with how I came up with that number. Maybe in the USA it’s cheaper for your pump supplies perhaps?

@jojojovich - I second Betty J with seeing a CDE or pump trainer. I wish I’d had that available to myself, but where I live here in Quebec (Canada) - it’s like looking for a needle in a haystack. I was using the book by John Walsh - Pumping Insulin for about 3 years prior to going on the pump - to educate myself on using MDI as my “poor man’s pump”. Right now, I’m averaging about 7 shots a day, of course, 2 shots are my basal (Lantus). I’m going on holidays tomorrow for 3 weeks - so it’ll be a good test to see how I do with the basal side of things - since I’ll be more relaxed and more active - so will probably be lowering my rate - just like you would with an insulin pump. Usually on holidays, I take way less insulin, as I’m sure some of you are nodding in agreement with me :slight_smile:
So, off I go to continue to pack. I may still bring the pump along with some supplies, incase I decide to go back. Have been meaning to do this before going on holidays, so I could tweak my basal rates incase they have changed since April, but every morning when I woke up, and meant to switch to the pump … I was darn lazy, and just injected and say “Tomorrow is another day …” - no I’m not Scarlett O’Hara from Gone With The Wind - tho’ I’m thinking of making a prom dress from curtains for #D-prom (those of you who Twitter and join on Wednesday at 9:00 p.m for the #dsma chat you’ll understand what I mean about the d-prom ).

Yeah, on MDI, I don’t even count how many shots I take a day. I’m lucky and have insurance right now so I am using it to take advantage of the DexCom, just take insulin whenever I need to, and am trying to stay as low carb as possible to basically avoid insulin use as much as possible. Too, I feel puffy if I eat even one sandwich or taco, so overall I think it’s healthier.