People are often surprised when they find out I’m not using an insulin pump and there are 3 big reasons for this:

  1. I don’t like receiving insulin via a line (tubing).

  2. My absorption is better using pens.

  3. I never disconnect from my basal rate.

I’m not trying to convince anyone to ditch their pump but I do encourage knowing your options.
First, get insightful about your challenges with the pump. Do you suspect absorption issues, is your skin reacting badly, do you find yourself disconnecting often and then chasing highs because you’ve been short on insulin for too long?

Taking action on these questions changed my management style and helped me to develop healthier habits with multiple daily injections or MDI.

MDI has eliminated the uncertainty of insulin absorption from a poor site, and I have healthy skin around my stomach, hips, and thighs, because I can rotate injections more frequently. One major aggravation with the pump was that I had a knack for wrapping the line around door handles and pinning it while I slept, causing tension that pulled the insertion out during the night. Total hassle.

A habit I needed to change and that I see other people doing is disconnecting for extended periods of time, particularly during exercise. When I wore a pump I was living near a beach and I was constantly taking it off to swim, shower, and exercise. It was actually a huge problem because I would find myself without any insulin for hours over the course of a day!

Physical activity is definitely not a time when we want insulin levels at zero. You likely need to adjust your rates on the pump specific to the type and duration of activity. If you find that you have to completely disconnect the pump every time you exercise to avoid lows there is a bigger picture to look at over a 12-24 hour period, so that you get the right amount of insulin you need, at the right time, to match your nutrient needs, and energy level.

Insulin is a powerhouse hormone that helps build and preserve muscle tissue -a positive trait not often talked about in the diabetes world. This hormone is completely natural, we will always need it, and that makes us no different than people who make insulin themselves. Insulin is the good guy we want doing the work on the inside but in an amount that is natural to our physiology, which is the challenge with T1D. Yet, it can be understood through self-study, strategic timing, and healthy nutrition.

Please comment below if you find this article helpful and please share with your T1D pals!

As always, you are not alone. Consult your care team when adjusting insulin rates.