Five Reasons Why I Choose Multiple Daily Injections

Since the day I was diagnosed, I have had people telling me I should consider an insulin pump. Seven and a half years later, I still say no. My A1c has always been in a healthy range, and I am fine with only having one device, the Dexcom G6 continuous glucose monitor (CGM), on my body. I know pumpers rave about their tight control and I am truly amazed by the pump’s capabilities, even more so now with the new features on the Medtronic 670G. However, I prefer a KwikPen, which is true to its word — it is quick and easy and just the way I like it!

Here are my five top reasons for being on team MDI (multiple daily injections):

1. No Kinks or Knots

I constantly hear stories of people waking up with a blood sugar in the 300s, and they had no idea. This is because there was a kink or knot in their tubing and the insulin wasn’t getting into their body all night long. Yes, if they are wearing a continuous glucose monitor (CGM), it should have alerted them, but that sounds like a pain you don’t get from the poke of a pen!

2. Fewer Bruises and Scar Tissue

Don’t get me wrong, the pokes of 6-8 injections a day does add up, and I do have bruises on my body. But have you seen the needle on those pump infusion sets? They are a lot longer and thicker than my Humalog pen. Also, the cannula stays in your body, therefore, leaving much larger holes. This means more bumps and bruises and also means more scar tissue.

3. No Crazy Calculations

As I mentioned above, I am amazed at what a pump can do. It can give you a precise amount of insulin right down to the decimal point. It can also tell you what your insulin on board (IOB) is. My pen can’t do either of these things! However, I do use Humalog Luxura, which is a half-unit pen so I can get more accurate dosing. Also, I mostly eat low-carb, so my dose is usually between 1-3 units. I prefer not having to count every carb I consume; math is not my strong suit!

4. Quick and Easy

KwikPens are quick and easy and take one second to use! I compare these seconds of my day to a lifetime of walking around with another device attached to me, tubing included, and that’s just not for me. Between CrossFit and being a mom, the tubing would not be kind to me.

5. I Don’t Have to Carry Around My Pancreas

When people first recommended the pump, I really only focused on not wanting to wear something else attached to my body. What I didn’t consider was the fact that I would have to actually carry around my new pancreas! When I went to my first type one weightlifting event, Bolus & Barbells, I was so surprised to see everyone with their phones in one hand and their stand-in organ in the other. I imagine that showering and going to the bathroom is a little more challenging than it is for the average Joe!

Photo by Allison Caggia

While I know there are many benefits to wearing a pump; it is just not something I am considering at this time. For me, the fewer reminders of this disease, the better. And with another device attached to me, especially with tubing, I would feel tethered. If I were to consider a pump, it would be the Omnipod since it is tubeless. For now, I will remain loyal to team MDI.

Are you someone who is on multiple daily injections and won’t have it any other way? Or are you someone who was MDI and made the switch to a pump and are glad you did? Share your story!

A previous version of this post has been updated.

Source: diabetesdaily.com

How to Safely Transition to Multiple Daily Injections (MDI)

As the reality of living during a pandemic slowly starts to sink in, people are changing their expectations for what 2020 (and beyond!) looks like. Some people have delayed their weddings, or put plans for a baby on hold, and many people have lost their jobs.

In the US, where health insurance is so intimately tied to employment, which also, unfortunately, means that many people are currently without health insurance and are quickly searching for a plan that will work for them. This is infinitely more complicated when you’re living with diabetes, as health insurance is even more essential for your health and well-being, but this can also cause problems.

Coverage for diabetes supplies varies by insurance carrier. For example, many Medicaid programs across the United States do not have an adult CGM benefit, and some health insurance plans on the federal and state health exchanges will not cover the type of insulin pump you need and are used to. These transitions have many people considering a switch to MDI, or multiple daily injections. Here’s how to transition safely, if this is you.

Reasons for Switching to MDI

People may switch from their insulin pump back to multiple daily injections for any number of reasons, but some may include:

  • Needing a mental health or “tech” break
  • Diabetes burnout 
  • Not wanting pump sites and tubing during the summertime (when lots of heat, humidity, pool, and beach time can cause many headaches with sites coming out more frequently)
  • Losing health insurance, and new insurance doesn’t cover your preferred pump
  • Saving money (a 2019 study found that annual costs are ~$4,000 higher for pump therapy than for MDI therapy: $12,928 vs. $9,005, respectively)
  • Experiencing frequent pump and/or cannula malfunctions
  • Experiencing sensitive skin and adhesive issues at your pump site
  • Absorption issues with insulin pump therapy

Some people switch pretty frequently between insulin pump therapy and daily shots, while others stay strictly in one camp or the other for years, and only switch when they absolutely have to. Remember that you don’t have to justify your reasons to anyone.

Talk to Your Doctor

Once you’ve decided to switch back to MDI, you should contact your primary care physician or endocrinologist (or any other provider who you regularly see for diabetes care). They can help you develop a plan to convert your basal (pump) settings to a long acting insulin injection (Lantus, Levemir, and Tresiba are common brands). Additionally, they can help you navigate the transition for bolus doses, as well as help you figure out your insulin sensitivity and correction factors.

Stock Up on Supplies

Once you’ve spoken to your doctor (and have gotten some prescriptions for long-acting insulin), it’s time to stock up on supplies. You’ll need both short and long-acting insulins (for bolus and basal insulin replacements), syringes or pen needles, and alcohol swabs. It’s helpful to have plenty of low snacks, like juice and glucose tablets, on hand as well. A silver lining of MDI is that there are way fewer supplies you’ll need, and they cost less money.

Buckle Up for the Roller Coaster

Switching back to MDI after using an insulin pump will not be without issues. You may experience both more frequent high and low blood sugars as you navigate the transition, and figure out both how much and how frequent you need to dose insulin. Don’t be surprised if you find that you need much more insulin on injections than you needed on a pump (or vice versa). Everyone is different, and having a little patience (and plenty of low snacks handy) can go a long way.

Listen to Your Heart

It’s important to remember that people living with diabetes can have excellent control whether or not they use an insulin pump. Multiple daily injections is a form of diabetes therapy that works wonderfully for millions of people. That being said, you may have family or friends who will try and change your mind about switching back to MDI. Be let’s be clear: if you need a pump break (for ANY reason), listen to your heart. Don’t let people talk you out of it. Diabetes is for the long-haul, and sometimes taking a break (or going back to insulin injections permanently) is just what can be needed to achieve better physical and emotional health.

You Can Always Change Your Mind

Made the switch to MDI, and can’t stand it after 2 weeks? Remember, your diabetes management is just that, yours! No one will judge you if you are ready to go back on insulin pump therapy sooner than you anticipated. You are allowed to change your mind as many times as necessary to find the best therapy that will fit your lifestyle and meet your needs most effectively.

Have you made the switch to multiple daily injections from insulin pump therapy recently? How was your experience? Any advice to share? Please share your story below; we love hearing from our readers!

Source: diabetesdaily.com

Diabetes Pro Tip: All About Multiple Daily Injections (MDI)

This content originally appeared on Arden’s Day and the Juicebox Podcast. Republished with permission.Jenny Smith, CDE discusses the ins and outs of using insulin multiple daily injections (MDI) to manage diabetes. Learn more by listening to the podcast and share your thoughts with us in the comments.
Source: diabetesdaily.com

I Thrive: Running Towards Health

Meet Brian Hoadley. A 38-year-old normal guy from the UK working as an operations manager for an office furniture supply company. Enjoying life and living as most of us do, spending time with friends and family and his wife, when out of the blue, Brian was diagnosed with Type 1 diabetes in 2014 at the […]
Source: diabetesdaily.com

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