Living with type 1 diabetes (T1D) requires perpetual insulin delivery. There are three primary methods to administer insulin: injections, inhalers (if you are at least 18 years old), and pumps.
Many manage T1D it with multiple daily injections (MDI). The exact number of injections varies from person to person, and comes in the form of long-acting and short-acting insulin. Long-acting is meant to mimic the body’s natural insulin production, while short-acting is administered to account for the glucose intake from food, given at mealtime, and to correct high blood-sugar levels.
Injections typically occur at regularly scheduled times during the day. Syringes or pens are both used for injections, but both essentially do the same thing. Some people find the pen to be more convenient when they only need a single kind of insulin. Some children also find the pen needles more comfortable than the syringe needles.
Afrezza, a quick acting inhaled insulin, can be an alternative to injectable pre-meal insulin. It is inhaled immediately before a meal. It is FDA approved for people 18 and over who have type 1 or type 2 diabetes. There are other criteria for use that your physician and diabetes care team can provide.
An alternative to injections is the pump. The pump is a computerized device, about the size of a beeper or pager, often worn on a belt or in a pocket. The pump delivers a continuous low (basal) dose through a cannula (a flexible plastic tube), which attaches to the body through a small needle inserted into the skin. The cannula is taped in place and the needle is removed. Common insertion sites on the body include the thighs, buttocks, abdomen, upper arms, and other areas with fatty tissue.
When a person wearing a pump eats, she pushes a button on the pump to deliver an extra amount, called a bolus, to provide insulin for their food.
The advantages of the pump include:
- Greater flexibility with meals, exercise, and daily schedule
- Improved physical and psychological well-being
- Smoother control of blood-glucose levels
The disadvantages of the pump include:
- Risk of infection
- More frequent hypoglycemia (low blood sugars)
- Ketosis and ketoacidosis (risk of very high blood sugars) if the system is disrupted
- Constant physical reminder of diabetes