In defence of multiple daily injections

By | 19 June, 2009

As we all know there are a few choices when it comes to managing Type One diabetes. We can rely on multiple daily injections (MDI), using a pump or other solutions – such as homoeopathy. The latter option usualy results in a slow, lingering death and other answers, such as inhaled insulin are just rubbish. So it’s basically down to MDI or pumps.

For the last wee while, pumps seem to be given as the must-have diabetic accessory. Without one you’re seen as a throwback to the early 20th century, having little progressed from the days of Banting and Best. Essentially you’re the diabetic equivalent of the caveman (or, of course, cavewoman) – a drooling, half-mad imbecile pitied by the pump-wearing community.

Well, the tide has turned my friends as I’m coming out in support of MDI!

“For God’s sake, why?” You may ask. Well, in my view MDI has a lot going for it. No, it really does.

The main benefit of MDI is its simplicity. There’s no complicated machinery for one thing. I haven’t been able to set the timer on any video player or DVD recorder I’ve owned for the last ten years. That I might be put in control of a complex device on which my life wholly depends is frankly terrifying. If I had a pump I would end up with the diabetic equivalent of my favourite program being recorded over by a repeat of Masterchef – as happens with monotonous regularity with my video (whatever the diabetic equivalent of that could possibly be…)

Second; MDI is extremely portable, robust and virtually indestructible. Should I choose to go out hoola-dancing in a grass skirt on a tropical island (now that’s going to be a hard image to shift…) then I can do that without the slightest difficulty. A quick squirt of humalog and I’m away. There are no problems wondering where I’m going hide my pump in my grassy skirts or whether the mile of tubing I have attached is going to pop out during the wild equatorial festivities.

It’s also worth remembering that contrary to popular belief you can actually maintain very good control with MDI. I don’t like to brag (well, actually I do) but my last five A1C’s have all been 6.5% or below – all achieved by just using simple old humalog and basic lantus. By carefully adjusting the long and short term injections you can get a really good balance that’s just right for you. If you can do this with basic equipment then why bother with the expense and complications of pumps?

So there we have it – MDI rules and pumps suck! Comments below please – bring it on!

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