A Day In The Life: MDI VS. Insulin Pump Therapy with CGM

A Day In The Life: MDI VS. Insulin Pump Therapy with CGM | The LOOP Blog

As someone who has lived with diabetes for over 11 years, I have experienced life with multiple daily injections (MDI), as well as an insulin pump therapy and continuous glucose monitor (CGM). Either way, I am still living with diabetes, but these two lifestyles are fairly different in the way I manage my disease, and also my day. Let’s go through my typical day, from waking up to going to sleep, on MDI versus an integrated insulin pump with CGM.

Morning

My first alarm goes off, typically followed by a few snooze buttons.

MDI: Wake up, check blood glucose (BG) to see how well my basal insulin worked overnight.

Pump: Wake up, view my sensor glucose (SG) on my pump, and check my BG to see how well my basal settings on my pump worked overnight.

Meals and Snacks

MDI: Check BG, count the carbs I’m about to eat, do the math to determine how much insulin is needed, draw up a syringe of insulin (or the proper amount in an insulin pen), and take the shot.

Pump: Check BG, count the carbs I’m about to eat, input my BG and grams of carbs into the Bolus Wizard, and press ACT.

Throughout the day, I’ll often pull my insulin pump out of my pocket to glance at my SG levels. I look for trends on the graphs provided by the CGM to determine if I need to wait a little longer to eat or if I need to take a BG and have some sugar sooner rather than later.

Post Meal/Snack BG Tests

MDI: Take a BG. If I’m high, I draw up a syringe of insulin, and take the shot.

Pump: Check my sensor glucose (SG) on my pump, and if I’m high, check my BG. If my BG is high, I put my BG into my Bolus Wizard, review the Bolus Wizard recommendation, and press ACT.

Mid-Day

MDI: Do nothing until I start to feel my BG levels dropping, so I test my BG and am low, so I have a snack.

Pump: The Predictive Low alert from my CGM goes off, alerting me my blood sugar is going low. I test BG and am low so I eat a snack to head off the low before I start to feel bad.

Exercise

Before exercising, I test my BG to see where my number is and determine if I need a quick snack or some juice before exercising. After that, it’s time to just hit the gym and work out.

MDI: Do nothing

Pump: With the pump still on, I tuck it away so it doesn’t flop around. In the middle of my workout, I glance down at my pump to look at my SG trend to see if it’s steady or trending downwards. If so, I take a break, check my BG, and have some glucose if needed.

Post Exercise

I always test after exercising so I can see if my BG is dropping, staying at a “good” level, or if I need to correct.

MDI: If I’m high, I’ll correct the same way as earlier. If I’m low, I’ll eat a snack.

Pump: If I’m high, I’ll correct using the Bolus Wizard, and if I’m low, I’ll eat a snack. After checking my BG, I may or may not do an infusion site change, depending on how long I’ve been wearing it or whatever else the reason may be.I insert the infusion set, and refill my reservoir if needed.

Middle of the Night

MDI: I wake up in the middle of the night sweating and feeling shaky. I know my blood sugar is low and need juice right away. I test my BG to determine how much sugar I need to correct the low, and drink some juice. Then it’s back to bed to fall asleep.

Pump: The Threshold Suspend alarm went off and woke me up, so I check my BG, determine how much sugar I need to correct, and drink some juice. Depending on my BG, I’ll either suspend the insulin delivery, or clear the alarm before going back to sleep.

On MDI, by the end of the day, I have taken 9-10 insulin injections via syringe or insulin pen. Using an insulin pump has made my life easier and is what works for me, which is why I made the decision to pump. The most important factor is deciding what works best for you.

Important Safety Information

Medtronic Diabetes insulin infusion pumps, continuous glucose monitoring systems and associated components are limited to sale by or on the order of a physician and should only be used under the direction of a healthcare professional familiar with the risks associated with the use of these systems. MiniMed 530G with Enlite is intended for the delivery of insulin and continuous glucose monitoring for the management of diabetes mellitus by persons 16 years of age or older who require insulin.

Pump therapy is not recommended for people who are unwilling or unable to perform a minimum of four blood glucose tests per day. Insulin pumps use rapid-acting insulin. If your insulin delivery is interrupted for any reason, you must be prepared to replace the missed insulin immediately.

The information provided by CGM systems is intended to supplement, not replace, blood glucose information obtained using a home glucose meter. A confirmatory fingerstick is required prior to making adjustments to diabetes therapy. MiniMed 530G with Enlite is not intended to be used directly for preventing or treating hypoglycemia but to suspend insulin delivery when the user is unable to respond to the Threshold Suspend alarm and take measures to prevent or treat hypoglycemia themselves.

Please visit www.medtronicdiabetes.com/importantsafetyinformation for more details.

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