Insulin Pumps

Multiple Daily Injections, a Second Time Round

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I definitely felt hesitant about going back to Multiple Daily Injections when I was contemplating a pump break.

I didn’t really have too many fond memories of managing diabetes prior to insulin pumping. Lantus was very uneven and inconsistent the last time I used it. I felt I could never get the dose quite right. I remember lots of carb guesstimates, and the wildly fluctuating levels that followed.

But at the same time I knew that I was armed with a lot more knowledge, and motivation compared to when I last did injections. I was actually curious as to whether I could apply these newfound skills into Multiple Daily Injections a second time round.

I gave 9 units of Lantus at around 9pm on the first night of my pump break, which was the sum of the 24 hour basal profile on my pump. I was pretty pleased to see that it did keep me fairly stable when I woke up the next morning.


I was definitely contemplating splitting my Lantus dose, but I wasn’t sure how best to go about it. The general consensus in forums seemed to be that Lantus lasted around 18 hours at best. After running high during the first two afternoons, I decided to experiment with a smaller second dose at 1pm to cover the final third of my day. 3 units seemed to be enough to cover, without sending me low overnight.

After months of diligent carb counting, I knew I definitely wouldn’t be able to survive without a bolus calculator. Although there were plenty of flashy diabetes apps to choose from in the App Store, many of them lacked a bolus calculator. I eventually found RapidCalc for $12.99. Although it didn’t have the flashiest interface, it fitted my needs nicely. I was able to set up my insulin to carb ratios, correction factors, insulin usage profile, and reminders for my Lantus doses.


This break definitely reinforced that to me that you tend to use less insulin on the pump. On the pump, I was using a carb ratio of 1:10g and a correction factor of 1:2.6mmol. On injections, I needed a ratio of 1:6g and a correction factor of 1:1.6mmol. Being off by even half a unit of insulin had a big impact on my blood sugar levels after meals.

What I loved most about injections was the simplicity of it all. There was instant relief from the lows, and far less thinking about where my blood sugar was heading. Small activities around the house had minimal effect on my blood sugar levels. I witnessed steady trend arrows on my Libre during afternoon walks, rather than downward ones. Using Lantus for my basal, rather than rapid acting insulin on the pump, made a BIG difference here. The only time I had to think about lows was when I had mealtime insulin on board.

Gotta say, it was also just awesome to sprawl out on the couch or in bed and not feel that chunk there in my pocket. And I loved having a little less weight in my pockets every time I left the house.

Overall, my blood sugar levels were just as good on injections as they were when I was pumping.

But shots were definitely a LOT of work. Although I carried my pen around with me in my pocket everywhere, I don’t shoot up in front of others. So I really had to make a point of finding a quiet corner to do so when I wanted to eat or correct a high blood sugar level. Speaking of, morning blood sugars were a LOT harder to manage. I didnt have the flexibility of increasing my basal insulin to cover the morning rise after I woke up. I often found myself giving at least 3 corrections after breakfast to bring me back into range. If I had stuck with injections for longer, I would definitely basal test with a few extra units of rapid acting insulin to cover the morning rise.

My pump break definitely reminded of something that Ginger at Diabetes Daily wrote recently. She says that neither pens or pumps were perfect, and that we were choosing between the flaws that bothered us the least. I couldn’t agree more.

For me personally, an insulin pump is a LOT more work than injections. Keeping on top of site changes, dying batteries and insulin cartridges, and having to be on my game in setting basal rates around my activity. It’s more careful thinking about what you’re doing. Not to mention the extra chunk in my pockets pulling my shorts down!

But a pump also offers me more convenience when I’m on the go, more precision in my basal rates and greater flexibility with insulin dosing to cover different kinds of meals.

For the time being, those benefits outweigh the flaws when managing my diabetes.

Taking a Break from My Insulin Pump

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I spent two weeks disconnected from my insulin pump last month. It was honestly the best decision I could have made for my diabetes management in the long run. Going back to the simplicity of injections gave me some much needed relief from the stress the pump was inflicting on me, as well as a lot of time to reflect on how I wanted to manage my diabetes going forward. With a much clearer head today, I will add some more to what I wrote about this pump break last month.


As we were heading into warmer weather and the festive season towards the end of last year, I was spending a lot more time being physically active. Watering the garden, Christmas shopping, setting up Christmas lights and activity around the house. Suddenly, a lot of what I had learned and experienced over the past few months from using an insulin pump had changed.

Being plugged into rapid acting insulin all the time felt exhausting. I was going low all the time. Even simple things, like watering the garden, would send my blood sugars spiralling downward. I felt like a single day without a hypo was rare. I often found myself eating my way out of impending hypos, and trying to predict what my blood sugar levels were going to do to me before leaving the house.

I felt really, really lost. I had very little confidence in my basal rates, or insulin to carb ratios. I had no idea whether it was my basal rates, or my insulin to carb ratios that were sending me low. I no longer felt safe leaving the house for half an hour without a meter and tonnes of skittles to fall back on. I’m pretty sure I had made the connection between physical activity and my lows, but I just felt far too overwhelmed at the thought of fine tuning everything once again.

I was nervously pacing up and down on a Friday night in December, deliberating over a site change or a Lantus injection. I was equally scared about going back to using Lantus, given how uneven and inconsistent it had been for me in the past. What finally got me over the line was telling myself that insulin pumping was no longer working for me. I knew that it was the source of all of this frustration, and that I didn’t need to use it if I didn’t want to.

The days that followed were quite honestly the happiest I’d felt in several weeks. The freedom from that annoying chunk of a pump, and the relief from not having to stress about basal insulin sending me low from a short walk. I was honestly so happy at the time, I was convinced that this might be the way forward for me. I was so relieved, I kept telling myself how much better injections were compared to the last few weeks I’d had on the insulin pump.

I went from having days like this.


To having days like this.


I anticipated I’d probably only last a few days without my pump. But injections were going surprisingly well for me. Everytime I stared at my pump, I just knew that I didn’t feel ready to hook back onto it. At the one week mark, I even stashed it in a drawer because I didn’t want to look at it.

My pump break gave me some much needed time to clear my head. I plugged back in for a few days over Christmas, because I knew that I would need the temporary basal rates and extended boluses to help me cruise through all of the food. I was fully prepared to take it off again after Christmas, but quite honestly I haven’t felt any desire to do so since.

I’ve been setting temporary basal rates around physical activity, and they seemed to do the trick from the get go with minimal hiccups. I’ve been setting a -30% temporary basal rate before I get into the car to go to the shops, and switching my insulin delivery to “off” for half an hour if I go for a short walk around the block in the afternoon. I think I’ve had about 2 or 3 hypos in the New Year, which is not only a big relief, but tells me that I must be doing something right. 

If it weren’t for Christmas, I’m not sure whether I would still call myself an insulin pumper today. In those two weeks, I was absolutely fine with the possibility of going back to injections permanently if that was what worked best for me. 

At the moment, things are travelling well with the pump. Things are making sense once again, and I honestly have not felt any desire to be without it since Christmas. 

Could this change again down the track? Who knows? This is diabetes, after all…

What I have learned, however, is that I absolutely will not hesitate to take a pump break if the need arises again.

My diabetes, my rules…

Pump-less in December

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I was staring at the infusion site on my stomach that needed to be changed on Friday night, and all I could think to myself was I really don’t want to do this. 

I thought about the stressful week I had just had. I thought about all of the running around I’ve been doing lately, and the hypos that accompanied the running around. Spontaneous activity is so friggin hard to plan for. How can I possibly guess when I’m going to get the urge to vacuum my bedroom floor, fiddle around with the Christmas lights that have fallen, or water the garden – and set a temporary basal rate an hour in advance to stop me from going low? This was hardly an issue on Multiple Daily Injections.

It was 37 degrees on Friday, and the pump just added to the hot weather discomfort. That lump in my pocket was a cozy comfort during the Winter, but now it just annoys me. Every time I sprawl out on the couch, or lay down in bed, its there. Every time I have to stop and tuck the excess pump line back into the waistband of my shorts, only to have it emerge again soon after. Every time it weighs down my shorts with all of the other crap I carry around when I leave the house, and I’m left pulling up my pants every five minutes.

I’ve definitely been cruising a little more than I would normally allow myself. Hello, December. I had two iced coffees last week. At 69g of carbs a pop, it’s not something I can usually justify consuming, especially being in liquid form. I’ve been treating myself more often than I would usually allow, and carb considerations cross my mind less often than they usually do. Maybe a break would give me time to refocus?

I love my insulin pump. I love the added precision, and extra flexibility that it allows. Having an insulin pump has really motivated me to more actively manage my blood sugar levels and count my carbs. In seven months, I don’t think I’ve ever seriously considered abandoning my insulin pump.

But I was already daydreaming of being free from my pump. I was excited by the idea of shaking things up and doing something different, in the same, refreshing way that going Libre-less was.

I have learned so much about my insulin dose requirements since starting out on a pump, and I couldn’t help but wonder if I could apply this logic and newfound diligence into Multiple Daily Injections a second time around.

With Christmas just around the corner, I doubt that this pump break will last very long. But for a few days at least, I will savour the freedom of not having to feel for a flying pump every time I get up off the couch, and the extra space in my pockets.

Pressing a Button

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“Go on. Take it!” One of my work Mums urged me at a plate of sweets she had brought in.

“Crank it up, Frankie,” my other mate added.

I definitely knew I was going to dive in and have something. But I was hesitating for a moment, while deliberating over a carb count and giving myself time for the insulin bolus to kick in.

Don’t get me wrong, my decisions around my food are my own. Sure, my work mates see me pull out my pump from time to time. They see me scan my FreeStyle Libre frequently while I’m wearing it. They see me drink coffee, eat sweets, laugh and do all the other “normal” things.

But I don’t think they actually appreciate just how complex these seemingly simple actions are.

Like making sure that bolus is delivered prior to eating. Making sure that I think carefully about the carb count I’m estimating. That I give enough insulin not to send me high after eating, but not too much that it will send me plummeting within an hour. Factoring in physical activity, and not being too reactive with insulin corrections.

As we were resting later, I pulled out my pump once again.

“You check it all the time?” She asked me.

For both of our benefit, I gave her a much, much simpler response.

“Yes. Whenever I eat, I pull this out and press the button to get my insulin” I replied.

“It’s better than injections?”

“It’s so much easier than before. If I want to eat, I can just press the button. If my blood sugar is high, I can just press the button, instead of having to stop and give an injection.”

I wish managing diabetes was as easy as pressing a button. But it’s nice to dream.

Working Towards a Lower hba1c

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I am only two weeks away from finding out what my latest hba1c result will be. And I am dying to know.

In August, I learned that my hba1c had gone up after three months on a pump. I was extremely disappointed at the time, but did take solace in the fact that my BGLs are far less variable than they once were. 

I’ve been working hard at taming my blood sugar levels over the past two or so months. I do genuinely feel like I am making progress and taking steps in the right direction. But there are definitely still some tough spots that are taking time to work through. 

Routine has been key to taming my blood sugar levels. Through the week I generally wake up, go to work, have my meals, come home and go to bed at the same time each day. Having that sort of consistency makes it easier to experiment, compare and make adjustments to insulin doses.

Nights have probably been the most consistent. I still wake myself to check once through the night. Sometimes small correction doses are needed, but I am waking up in range almost every morning.

Mornings are probably the smoothest portion of my day, blood sugar wise. It is still extremely tough to obtain consistent results, because I begin work at 7am with varying levels of physical activity from day to day. While breakfast on Monday left my levels smooth sailing, the exact same breakfast (and an identical waking BGL) yesterday sent me a little higher than I’d like. As much as I try not to beat myself up, this is ever so frustrating!

Afternoons have been somewhat tricky to smooth out. I sit down to lunch for an hour at 1pm after a morning of physical activity, which means I need a higher basal rate in action for this hour alone. I go back out to work at 2pm for another hour of physical activity, before finishing at 3pm where I once again need a higher basal rate of insulin. It’s definitely been a loooong game of trial and error, with many curse words thrown towards the sight of upward trend arrows on my FreeStyle Libre. Urgh.

Speaking of FreeStyle Libre, it is a lifesaver. Having easy and unlimited access to glucose monitoring means I have greater insight into what’s happening with my levels. Adjustments are easier to make, and I can better respond to highs and lows. Like this low, that rebounded high, and ended miraculously in a steady line.

 It’s becoming hard to live without it (first world problem, I know…).

Evenings are probably affected a little by my afternoon levels, and I’m confident that they will be easier to manage once my afternoon basal rate is right. My evening meal is also a cooked one, meaning that my carb counts are more estimated and varied than others. 

I am also being super diligent with my eating. I am putting more effort into preparing my meals and snacks through the day. This has definitely resulted in more variety and enthusiasm towards the food in my lunch box (hello ham and eggs on toasted Sourdough), and less of a desire for junk food and unnecessary carbohydrates. I definitely want to expand on this in another post to come. 


I’m also noticing that my total daily dose of insulin is now both lower and more consistent, which can only be a good sign!

Which brings me to now. I am nervous. I have absolutely no idea whether I have done enough to make a dent in my hba1c. I’m trying not to be too unrealistic about my expectations, but I’d be lying if I said I didn’t have high hopes. If my average glucose readings are anything to go by, I’m expecting that I’ll be sitting around half a point lower to where I was in August.

I’m determined to make these last two weeks count. And not because I’m scrambling, like I did back in my diabetes juvie days. I’m watching my FreeStyle Libre reader like a hawk, and making those last minute improvements that will hopefully make all the difference.

I am absolutely dying to find out where my hba1c is sitting right now. Crossing my fingers and toes for November 9…