Diabetes Isn't One-Size-Fits-All: Why I Prefer Multiple Daily Injections with T1D

Why I Prefer MDI as a Person with Type 1 Diabetes (T1D)

I wrote about this last week, but wanted to expand on it today. I don't feel a need to explain myself. I write this only to offer some validation to others living with type 1 diabetes (T1D) who might be feeling like they're not up to date or doing something "wrong" while living with T1D.

First of all, you are doing nothing wrong.

If you have choices in your diabetes care, I want you to feel empowered to make ones that feel right for you! I will always support anyone in the diabetes community looking for ways to improve their care, overall health, and well-being. There is no one-size-fits-all approach.

While some people with T1D do well with insulin pumps, others prefer multiple daily injections (MDI) and are no less of a community member for doing so. It feels incredibly silly to even write that, but I've experienced criticism myself, so I know if I am, others are probably going through the same thing...

I Had to Prove Myself with MDI Before a Pump

As I explained last week, when I was first diagnosed with type 1 diabetes back in the early 2000s, the healthcare system required me to demonstrate that I could stabilize my blood sugar levels for a couple of years without using a pump. As a result, I became very accustomed to multiple daily injections (MDI).

An insulin pump wasn't an option for me under my family's insurance or my own for many years until I reached my mid-20s, at which time I tried Omnipod. When I finally had the opportunity to try this insulin pump, it didn't suit me enough of the time to stay on it.

Before I get any further, I want to clarify that this isn't meant to diss users of Omnipod in any way, shape, or form—Omnipod works really well for many people with diabetes. However, it just wasn't the right fit for me.

I wouldn’t want my experience to discourage anyone with any type of diabetes from exploring options they're interested in. Unless you try, you’ll never know what works for you, and I’m grateful for the chance to experiment. It taught me a lot about myself, how I prefer to take care of my health, and how I choose to manage my diabetes.

Overall, it was a transformative experience that I wouldn't change...to evolve, we must be willing to go through change. (Change will happen whether we choose it or not! It's the only constant.)

Julia Flaherty with Medtronic's InPen

This is Why I Prefer Multiple Daily Injections with T1D

Here are the main reasons why multiple daily injections (MDI) make sense for me as a person who has been living with type 1 diabetes (T1D) for over two decades:

No Extra Devices Attached (Except for My CGM)

First of all, I appreciate not being tethered to a pump all day. This was my primary reason for trying the Omnipod for a short period in 2021. I disliked the idea of having tubes sticking out around me, so the tubeless style really appealed to me.

Now, with MDI, the only device attached to me is my continuous glucose monitor (CGM), and that feels liberating. I have no shame in showing off my devices because they are essential for my survival. However, I am a bit clumsy and active, so I worry about accidentally yanking a pump off.

I know there are workarounds for that within the community, but I just don't care to explore that path.

No Risk of Accidental Self-Injection Instead of Filling the Pump

Another issue I had with insulin pumps is that I’ve become so accustomed to MDI that I worried I might accidentally inject myself with insulin instead of filling the pump. Insulin pumps require a significant amount of insulin, and since I’m used to MDI, I knew it would be only a matter of time before I mistakenly injected 200 units into myself rather than into the pump. That mistake wouldn't be survivable.

I have accidentally mixed up my basal and bolus insulins before, and that was challenging enough—20 units. Just imagine 10 times that amount! No, thank you! (I still feel sick thinking about all the regular 7-Up I drank that night.)

Less to Carry When Traveling

I enjoy traveling and have been abroad. Packing diabetes supplies can be tedious, and if I liked pumps enough, it might be worth the hassle. However, since I don’t, I see this as a definite advantage. Less to remember means less to forget!

More Mindfulness and Control Over My Blood Sugar Levels 

I feel that manually administering my insulin allows me to be more mindful and aware of my doses. In contrast, a pump might make me less engaged in my care. Don’t get me wrong—I sometimes welcome a break from constant diabetes thoughts, but when it comes to my injections, I prefer to stay sharp! I believe that if I had a pump, I might become complacent with my management, and I don’t want that.

However, I realize that for others, this may act in reverse. As I said, there's no one-size-fits-all! We all have different motivators and MDI motivates me best with my diabetes care.

MDI Isn't What It Used to Be

Multiple daily injections don't have to mean disconnections. While I had been using disposable pens for a while, I found a happy medium with incorporating Medtronic's InPen into my diabetes management routine over the past couple of years. I get a little more data and digital connection while staying in control with MDI.

I especially like the insulin on board (IOB) feature, as I am sometimes forgetful about when I took my last dose. Incorporating the InPen also helps me have more productive conversations with my endocrinologist, as she can more easily see the connections between my InPen and Dexcom G7 Clarity app.

I realize pumps typically come with even more data, but this truly feels like a happy medium for other T1Ds who prefer to stay on MDI but want a little something extra, like me. There is such a thing as too much information, too! Information overload can lead to burnout for some people with diabetes.

Less Insulin Waste

One major drawback I experienced with an insulin pump was insulin waste, which I had never experienced with MDI before. I could never get enough out of the pump reservoir when it was nearing the end of its life. Again, I'm sure there are workarounds, but I was not privy to those at the time I tried an insulin pump and didn't find the reimbursement program helpful when experiencing this incredibly disheartening challenge.

I hate insulin waste.

People with Diabetes Don't Owe Each Other Explanations

Overall, whether someone uses an insulin pump or multiple daily injections, no one needs to explain their preferences for diabetes management. What matters most is that you feel happy and healthy in your care. Different approaches work for different people, so if you're living with type 1 diabetes and reading this, I genuinely wish you well on your journey to finding the ideal management plan for yourself.

I celebrate everyone with diabetes, regardless of how they choose to manage it. As long as you feel content and healthy with your method and can comfortably maintain it, I am proud of you! While you don’t need my validation, think of this as a note of encouragement from a friend. We could all use a little more support in facing this relentless disease.

Let's continue to cheer each other on; living with diabetes is challenging enough without judgment from within our own communities.

I often focus on type 1 diabetes in my blog because that's my personal experience. However, I welcome and appreciate anyone who visits here with another type of diabetes, and I look forward to learning from you! I know there are many overlaps in our experiences, and I am excited to address those topics in the future on Chronically Climbing.

Julia Flaherty using Medtronic's InPen

What is your preferred diabetes management strategy & why?

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DISCLOSURE: I have not been compensated by any of the brands mentioned to write about their products. This is a genuine review based on my own experience living with type 1 diabetes (T1D) for over 21+ years.