Pump to MDI: Pleasantly Surprised

I know I haven’t written in quite a while, and mostly because I haven’t had time. I’ve had plenty to say, though, trust me. So I’ll try to spare you and give you the Cliff’s Notes version of what’s been going on the last two months since starting on MDI (multiple daily injections).

IMG_4204When I came home from the beach that day, I had no idea how long I would actually take a pump break for. Usually, it would only be for the weekend… if that long. I always felt much safer using an insulin pump for reasons like temp basals and such.

But in addition to feeling safer, I felt unashamed. It’s crazy — me, the advocate for those who prefer MDI and wish to inject anywhere they want to — was suddenly the one who felt too self-conscious to dose in public. With an insulin pump, I didn’t care. No matter where it was stashed, I would pull, shake, or shimmy that bad boy out and bolus without batting an eye to see who may be staring. Now? I find myself injecting in the car before going into a restaurant… or ducking into the bathroom.  In my mind, others are staring at me and judging me for taking my shot in public. I’m slowly getting out of this mindset though, and trying to move past it.

But, I’ve loved being tube-free. I went back on my pump last weekend because we were going to have pizza, which is something I have no idea how to dose for on MDI, and I wanted to be able to extend my bolus like I’ve always done. And, not wanting to waste the insulin, I stayed on the pump for 2 days before taking it off again. During which time, I constantly fumbled with where to put it and I almost ripped my site out practically every time I went to the restroom. It’s crazy how quickly I adjusted to being without an insulin pump. The freedom feels amazing.

My numbers aren’t worse on MDI as I expected either, but quite the contrary. My averages are roughly 10-15mg/dL lower than what they are on my insulin pump, to which I have been pleasantly surprised. I have no idea why there is a difference, but part of me wonders if actually injecting the insulin is better for my skin and metabolism verses an infusion.

IMG_4148Of course, it could be because of the awesomeness of the basal insulin that I’ve been using, Tresiba. I honestly love it. Out of all of the ones I’ve tried (Levemir, Toujeo, and Tresiba), it’s been the most steady, and as long as I bolus correctly for meals, my BG is not nearly as “swingy” as it is with other basal insulins. I don’t notice any peaks, and I can take it every 24 hours without worrying about it running out in my system.

Now, my pump warranty is up in 5 months. I’ve been on the fence about what to do — to get a new pump or simply keep going with MDI and use my current pump as a backup or if I wanted to switch over for a break or anything. Then comes the question of which pump to go with… to stay with Tandem, or go back to Animas or Minimed, or go with Accu-chek since I love their Expert and Connect system. I mean, it’s a big decision. It’s one that I have to be confident that I’ll be happy I’ve made as I’ll have that pump for another 4 years.

Either way… I’m happy and comfortable currently with my MDI treatment. It’s going well, and for the first time, I don’t feel the urgency to run and put my pump back on. It’s almost like… freedom.

Bolus Advice: MDI With Less Math

A couple of weeks ago, my husband and I went to the beach for the day after church. It was a nice, cool, breezy day and it was good to get away and relax for a bit.

We were on our way home, and we stopped to get a frozen yogurt treat with the kids. I bolused with my pump, and half way through, I received an occlusion. The second one for that weekend.

True, this may not be a big deal, but it was the final straw for me. It’s true — occlusions are things that come with the territory when using an insulin pump, and that specific event isn’t what had me frustrated. It was a lot of things:  having a curious baby who likes to pull on my tubing, sites that were seeming to fail after just 2 days, and the more and more frequent “bleeder” sites.

That last occlusion was it. We made it home and I pulled out my Levemir backup pen that my endocrinologist always gives me to keep on hand in the case of pump failure. I had no idea how this was going to go, but my frustration outweighed my fear of the unknown-to-me territory of MDI (multiple daily injections).


I took my total basal amount, added 20%, took the injection, and unhooked my pump. It’s been in my desk drawer ever since.

As soon as I injected the Levemir and started to get ready to inject for supper, I felt overwhelmed by things like accurately calculating doses and keeping up with IOB (insulin on board), and I quickly emailed my Accu-Chek rep and pleaded with her to chat with me that night or the next day to set up my Connect App in my phone.

Why would I need her?

See, Accu-Chek now has a meter, the Accu-Chek Connect, that connects to your phone via Bluetooth, and you can see your readings, log food and insulin doses, and even program the app to text your readings to a family member if you need help.


It also has an option for Bolus Advice. With this enabled (via prescription from your health care professional), you can use the glucose number that is sent to your phone to calculate insulin doses if you are a MDI user. To me, this is great because it’s like having the best part of the pump without the pump!


The app even lets you see how the calculation works, and whether you need to increase for correction, decrease for active insulin, or if you’re low — how much food to eat. It’s really intuitive.


I honestly don’t know that I would still be on MDI if it weren’t for this app. I’m loving being pump-free without having to be bogged down with math.

I don’t know how much longer I’ll be on MDI, but I don’t feel as if I need to rush. I feel comfortable to be pump free as long as I have help calculating my doses and keeping up with active insulin — which is exactly what this system does.

While the meter was provided to me at no charge, I was not asked to review it. This is my honest opinion from the bottom of my heart. I cannot be more thankful that there is a company that not only wants to create an insulin pump product, but also to help those on MDI to have the best care possible.