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Guest Post: Why I MDI.

Yesterday I wrote about a diabetes technology piece that works in my life.  But wearing a device - two or three devices, some of us - isn't for everyone.  Diabetes management varies like New England weather (hello, 95 yesterday and 68 today).  Today's guest post comes from Erin O'Neil, who eloquently shares her tale of why she went from pumping to injections.

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Thank you to the lovely Erin for sharing her words on SUM today!“Ohhh no no no no no! Ohhhh my goodness, oh my goodness. You have GOT to be kidding me!”

These are words of panic I had hoped not to have to utter on my trip to Thailand.

After four years of staying close to home for university, my best friend and I had decided to get a little crazy and head overseas for an adventure.

When I uttered those words, I was in a state of true panic, in a small town on the edge of Khao Yai National Park, 200km north-east of Bangkok and way way way into the mountains. In other words, I was a long way from home.

My pump had broken.

I know it was the heat. For most of the week since we had arrived, the weather had been downright sticky, and I’m pretty sure that Animas doesn’t expect that many of their insulin pumps will need to withstand constant 40o temperatures (well over 100o, for you Americans).

Luckily (thanks, Mom), I had brought a back-up system. It was back to the insulin pen system of multiple daily injections (MDI). I vividly remember sitting on my cot in partial darkness, listening to the sounds of a million insects in the muggy heat, sleep deprived and achingly tired from a day of train travel (think ‘rickety’ rather than ‘luxury’).

My brain isn’t working properly and I’m already riding a serious wave of high blood sugar. And now I have to remember how on earth to go about calculating a short-acting/long-acting insulin ratio.

Somehow, I managed. With the help of a good friend and a good bowl of something delicious (and a refreshing Singha to calm my nerves), I began to feel normal again.

And before I knew it, the rest of the trip had passed without incident and I was home again, safe and sound.
“Well,” said my parents, “let’s get you a replacement pump.”

It was covered under warranty, no additional cost to us. It would have been simple to do the exchange and be up and running and bolusing in no time.

But I hesitated. The last two weeks of vacation in Thailand had be wonderful not only because I was doing nothing but eating good food and laying on the beach, but also because I hadn’t once worried about that little machine.

This was more than two years ago now, and I’ve continued using MDI (multiple daily injection). I know that my control could be better – whose couldn’t – but for this time in my life, MDI works for me. When my pump broke on that frightening night in Thailand, I was heading into my fifth year of pumping.

I had forgotten how delicious it is to be unattached, to be able to wear an outfit without worrying where to hide the pump. To be completely and utterly naked.

Diabetes has already stolen a handful of freedoms from me. For now, I’m not willing to give up anything more than I have to.

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Thank you for your post, Erin!!  Erin works in public relations and communications in Hamilton, Ontario, Canada. She has been living with type 1 diabetes since the age of 14. You can read her blog at Oh Erin and follow her tweets at @oerinoerin.


I get what Erin is saying (which she did very respectfully and honestly!) There are many reasons I went off the pump but the main reason I stick with MDI is my A1c stays in the 5% range and I rarely go over 250 or under 50. I used to go over 350 a lot because of pump issues and it got to the point that I was a little paranoid of my pump so I decided to take a break. That break turned into 5 years now and counting. I love the pump but I love MDI more. And it shocked me to find that out.

I really appreciated this post. I've been Type I for 34 years and I still rely on MDI rather than a pump. While I completely understand how much the pump has helped many diabetics with tightening their control, I have been stunned (and a little hurt) over the years by the number of people who have told me that by not pumping, I'm not really taking care of my diabetes.

However, my A1Cs haven't drifted out of the 6% range in the last decade and my daily BGs don't usually vary wildly. Even my endo has said that if I keep presenting similar numbers, he's on board with my continuing to inject.

Sometimes I feel so old-fashioned for still using needles, but I'm healthy and in good control, and I think that's all that matters. It's good to know that I'm not alone!

We may have been separated at birth...well, when it comes to diabetes anyway. I, too, have decided to "kick it old school" with MDI. For pretty much the same reasons you have. My a1c's are usually in the mid 5's and have discussed this several times with my endo. I test quite often and my meter trends are for the most part on target. My endo refers to me as a human pump. With diabetes, we all must find what works well for us as individuals. Like they say, if it ain't broke don't fix it...and since our pancreases are broke we need something that works! Thanks so much for sharing.

I also choose MDI, but I don't go naked- I wear a CGMS (Dexcom right now).

I definitely appreciate my sensor breaks but I think that if pumping had as many benefits as sensor wear did for me, I'd have to wear it. Fortunately, I'm pretty good with the shots.

I haven't had a vacation from my pump in a while. Maybe I will that this summer, because I can't remember what it's like to be free like that .

Thank you, you make the majority of us who don't or can't afford to pump feel better. The DOC can make me think everybody pumps but apparently only 1 in 4 of us do. (Same goes for CGM which very few of us actually use.)

I really love this post because everyone always talks about the ways that the pump is better than MDI- which isn't always true! It really depends on the person. Personally, I switch back and forth, because sometimes I just plain don't feel like walking around with a needle in my side! Thank you for this post! keep writing:)

My 9yo daughter went back to MDI after 5 years on the pump when we went on a beach vacation 2 years ago. She still has no desire to go back to pumping. Her A1Cs are better than they were on the pump (which may be partly due to being well past the toddler years finally) so I can't really complain. I loved the pump but there are parts I don't miss, like middle of the night site changes when you don't know where that 400 came from.

Our son (9) prefers MDI's to pumping, and, honestly, as his caretaker there are a lot of advantages for his management. It really is a personal thing, and it's great we have choices.

Great post Erin, glad to have found you.

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