MDI vs Pump in Type 2 Diabetes


Depending on one’s health coverage, people with type 2 diabetes have a number of choices they can make regarding the management of their condition. Once someone with type 2 diabetes (T2D) must implement the use of insulin into their everyday life, they have a decision to make regarding how they would prefer to administer that insulin. Typically, there are two available avenues: giving yourself multiple daily injections (MDI) or utilizing insulin pump therapy.

MDI have historically been the first line of treatment for those with diabetes, while insulin pumps have only been around since the 1970s and have seen a great deal of technological advancement even within the last few years. Pump therapy offers continuous insulin administration and therefore requires the wearer to be trained by a professional so that they can manage their levels and administration very closely. Injections are cheaper on average as pump supplies can be much more expensive. According to some, there is also greater risk of developing diabetic ketoacidosis (DKA) when using an insulin pump, though many professionals feel this is always preventable if patients are staying on top of their levels.

For some, these reasons are enough to make them stay on MDI. But the advantages of the pump are also important to note. Typically, pump users see fewer sudden highs and lows and the delivery of their insulin is more accurate. The pump allows for more flexibility overall: wearers can go out and seemingly eat what they want because their pump will provide insulin support without them having to think about it. These are all major positives if someone with diabetes doesn’t mind having a permanent reminder of their condition attached to them. Being on an MDI regimen can mean giving yourself 90+ injections per month. By comparison, those who implement an insulin pump only undergo 10-12 insertion set changes monthly.

A recent clinical trial has indicated that overall, insulin pumps result in better controlling of blood sugar levels compared to multiple daily injections in people with T2D. “Study participants with type 2 diabetes on insulin pump demonstrated a mean reduction in A1C levels by 1.1 percent, versus only 0.4 percent for participants using MDI, and twice as many participants on insulin pump therapy achieved an A1C less than 8 percent than those on MDI.”

When all is said and done, choosing between being on MDI and the use of insulin pump therapy depends solely on the individual and the lifestyle they wish to lead. Consulting a physician’s help and the expertise of a certified diabetes educator is suggested should someone want to change their course of diabetes treatment.

WRITTEN BY Beyond Type 2 Editorial Team, POSTED 08/24/22, UPDATED 08/24/22

This piece was authored collaboratively by the Beyond Type 2 Editorial Team.