Having insulin dependent diabetes means you need to take matters into your own hands when it comes to injecting insulin. You can do this either with multiple daily injections (MDI), or with an insulin pump.
You probably know the deal with injections already - you use an injection pen or a needle to inject yourself at least 4 times a day. This includes injecting a long acting insulin once or twice daily as a background (basal) dose and then you’ll also inject rapid-acting insulin each time you eat or if your blood glucose gets too high.
The most common alternative to injections is an insulin pump – it’s a small device that continuously delivers insulin to your body throughout the day. You’ll set it to deliver a ‘basal’ rate continuously in the background, and you’ll then deliver extra ‘on demand’ doses of rapid-acting insulin to match what you’re about to eat or the exercise you’re about to do (‘bolus dose’).
With both injections and pumps, you’ll need to monitor your blood glucose level throughout the day to help you figure out how much insulin you need. You can do this using a finger-prick test, flash glucose monitor or continuous glucose monitor.
It’s expected that in the future, pumps will be able to continuously monitor your blood glucose levels, automatically calculate the amount of insulin required, and then deliver the right dose of insulin. This is known as an ‘artificial pancreas’ or ‘closed-loop system’, and they are currently under development by a few companies. These are not yet widely available for people with diabetes, so in the meantime, most pumps have ‘bolus calculators’ which help you calculate how much insulin you need.