There is no doubt that Insulin
has changed the lives of people with diabetes. The major hurtle with taking insulin is knowing when to administer the injections so that its affects are long lasting and don't interfere with the busy life of the diabetic.
Since the discovery and use of insulin, doctors have experimented with ways to better administer the drug so that the diabetic won't be restricted to having to eat on a tight schedule to avoid swings in Blood glucose
. Going too long between meals can mean a blood glucose crash, leading to a feeling of lethargy, dizziness, hand tremors, sweating and fainting. Eating too soon or having too much sugar without the proper insulin to balance it can lead to a spike in Blood sugar
levels and symptoms of excessive thirst, increased urination, and feeling tired.
The multiple daily injections system (MDI), sometimes called the basal/Bolus
system, is a new way to give flexibility to Type 1 diabetics. After studies done on the benefits of using an insulin pump, which uses a short acting insulin as appose to the once per day injectable insulin, doctors began to looking for alternatives for people who do not use an insulin pump to get better control of their blood glucose levels.
To understand the significance of how an insulin pump or multiple daily injects can help, you need to look at the types of insulin that are available.
Regular Short Acting Insulin
– Sometimes called soluble insulin, regular short acting insulin is given as a bolus injection prior to eating.
Long Acting Insulin
– Insulin that is given once per day and works for in 24 hour intervals.
– Used as a basal or background insulin when giving multiple injections per day.
– Extreme rapid insulin that has a half life of 3-5 minutes.
The multiple daily injection system gives the diabetic more control over their life and their diabetes. They're no longer forced to eat meals at a certain time as dictated by their treatment. The MDI also mimics the body's nature way of administering insulin. With a healthy Pancreas
, natural insulin is not administered until it is needed. The diabetic who takes care of monitoring their levels and adjusting their insulin can enjoy eating different size meals at different times of the day to make their lives more flexible.
Managing your diabetes is vital to the success of MDI, therefore, your doctor will want you to keep a close eye on your levels to make sure your body is handling the multiple injection schedule well. While there are many benefits, there is a downside to multiple daily injections.
First, not all people will feel comfortable learning how to determine how much bolus insulin to use before meals since, depending on what the diabetic is eating, the amount of insulin will be different. The idea of having to inject a different amount of insulin each time may make the diabetic nervous. If after a few weeks the diabetic is not comfortable, they may decide not to use MDI at all for fear of not being able to control their blood glucose.
If a person is not good about taking charge of their health, they may not be a good candidate for MDI. Only diabetics who are vigilant in monitoring their blood glucose, eating right and following the guidelines for MDI will be successful.
You'll need to make sure you spend times thinking about your meals and preparing a meal plan. If you like to be spontaneous, MDI may not be the best choice to control your diabetes.
For the diabetic who is squeamish about fingersticks, MDI is not good alternative since it requires the diabetic to do multiple fingersticks per day to check blood glucose levels, anywhere from 4 to 10 per day. In addition to the fingersticks, the diabetic will also be receiving multiple doses of insulin, adding to the amount of needles they need to endure per day. Although there are some diabetics who feel control over their diabetes outweighs the discomfort, and new products, such as the insulin pen, make it easier to administer insulin, some will be turned off by MDI because of the discomfort and work involved.
Another thing that must be watched mindfully is meal planning. If the diabetic is not good about planning well, there will be a tendency to gain weight because of the false sense of security it gives when the diabetic binges, whether on healthy food or on junk food. While the occasional indulgence might not affect the diabetic's ability to control their blood sugar and calorie intake, multiple binges can lead to weight increase as the insulin will store extra calories eaten as fat!
The decision to choose MDI or not is individual. The best thing for the diabetic to do when they want control over their diabetes is to discuss MDI as an option with their doctor.