Share:
What are the benefits of Multiple Dose Insulin (MDI) using a pen or a syringe?
| Actor | MDI | CSII |
| Glycemic control | Optimal glycemic control
is feasible for the majority of persons with type 1 diabetes who
have a relatively stable lifestyle May lower rates of severe hypoglycemia more than conventional therapy May improve hypoglycemia awareness because of fewer episodes of low BG |
Optimal glycemic control
may be obtained for those with frequent hypoglycemia on MDI, those
with erratic swings in BG or an erratic lifestyle and those with a
marked dawn phenomenon May lower rates of severe hypoglycemia more than MDI (Lenhard & Reeves, 2001) May improve hypoglycemia awareness because of fewer episodes of low BG |
| Equipment cost | Less expensive than CSII | Relatively costly: pumps cost $6,400 –$6,800 (Can) and infusion supplies cost $2,000 (Can) per year |
| Self-management education | Extensive
self-management education required for the adequate use of the
full system of IT, including use of scales, carbohydrate:insulin
ratios and other dose adjustments Minimal time is needed for pen or syringe operation |
Same self-management
education is needed as with MDI, with some adaptations for pumps Extra time needed for pump operation training (≈3 hours) Additional technical support may be required |
| Psychological impact | No visible indicator of diabetes | Acceptance of pump being
attached and being a visible indicator of diabetes is necessary Less frequent injections required Those with significant psychological problems tend to do worse on CSII |
| Flexibility | Meal bolus may be needed
to contribute to basal insulin levels and may limit flexibility
with timing Dose in one-half unit increments only Limited flexibility in changing basal rates |
Maximal flexibility with
meal timing and choices Dose in 0.05 unit increments Maximal flexibility in changing basal rates (hour by hour) and adjusting to variations in lifestyle events |
| Disadvantages/ risks |
Frequent injections May be more hypoglycemia |
Greater risk of DKA if
insulin flow interrupted Risk of site infection or contact dermatitis Hypoglycemia from ‘runaway pump’ has not occurred in U.S. for more than 10 years (Lenhard & Reeves, 2001) |
