WHY I MDI
People are often surprised when they find out I’m not using an insulin pump and there are 3 big reasons for this:
I don’t like receiving insulin via a line (tubing).
My absorption is better using pens.
I never disconnect from my basal rate.
I’m not trying to convince anyone to ditch their pump but I do encourage knowing your options.
First, get insightful about your challenges with the pump. Do you suspect absorption issues, is your skin reacting badly, do you find yourself disconnecting often and then chasing highs because you’ve been short on insulin for too long?
Taking action on these questions changed my management style and helped me to develop healthier habits with multiple daily injections or MDI.
MDI has eliminated the uncertainty of insulin absorption from a poor site, and I have healthy skin around my stomach, hips, and thighs, because I can rotate injections more frequently. One major aggravation with the pump was that I had a knack for wrapping the line around door handles and pinning it while I slept, causing tension that pulled the insertion out during the night. Total hassle.
A habit I needed to change was disconnecting my pump for extended periods of time, particularly during exercise. I had been living near the beach and I was constantly taking my pump off to swim, shower and exercise. This became a huge problem because going without any circulating insulin results in super high blood sugar and it would last for hours.
Physical activity is definitely not the time we want insulin levels at zero. The solution is to adjust the rate on the pump specific to the type and duration of activity. If you find that you have to completely disconnect the pump every time you exercise to avoid lows, there is a bigger picture to look at over a 12-24 hour period so that you get the right amount of insulin you need at the right time to match your nutrient needs and energy level.
Insulin is a powerhouse hormone that helps build and preserve muscle tissue -a positive trait not often talked about in the diabetes world. This hormone is completely natural, we will always need it, and that makes us no different than people who make insulin themselves. Insulin is the good guy we want doing the work on the inside, but in an amount that is natural to our physiology, which is the challenge with T1D. Yet, it can be understood through self-study, strategic timing, and healthy nutrition.
As always, you are not alone. Consult your care team when adjusting insulin rates.