For people living with type 1 diabetes and many of those living with type 2 diabetes (about 30%), taking insulin is an integral part of diabetes management. For people who take insulin frequently, two of the most common ways to administer insulin are insulin pump therapy and multiple daily injections (MDI) therapy. So, insulin pump vs. MDI—which is better? Working with your healthcare team to determine which option will suit your lifestyle and promote the best glycemic control can help you develop a routine that works for you and your unique needs.
What Is Insulin Pump Therapy?
Continuous subcutaneous insulin infusion (CSII), more commonly known as insulin pump therapy, uses small, computerized devices that deliver insulin in a way that mimics the body’s natural insulin secretions. To support glycemic control, insulin pumps deliver insulin in two ways:
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Basal/background insulin: a continuous dose delivered throughout the day and night, mimicking the profile of a long-acting insulin injection |
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Bolus/mealtime insulin: a surge (“bolus”) dose delivered near mealtime or to correct high blood sugar |
The pump is worn on the outside of the body, and insulin is delivered through a catheter (a flexible plastic tube). The pump is attached to the body at the infusion site using something called an infusion set (catheter and needle). The catheter is inserted through the skin into the fatty tissue with the help of a small needle and taped in place. The infusion set is replaced every few days.
With standard insulin pumps, the basal insulin rates are typically programmed into your pump with the help of your healthcare provider. Most insulin pumps come with a built-in bolus calculator to help you determine the proper amount of insulin needed for mealtimes based on your glucose levels.
Sensor-augmented pumps (SAPs) combine a continuous glucose monitor (CGM) and an insulin pump into a single system, allowing easy access to the sensor’s glucose information. Some closed-loop systems will automatically adjust basal insulin based on CGM readings.
What Is MDI Therapy?
MDI therapy typically consists of three or more insulin injections per day. This often includes one injection of long-acting insulin in the evening and an injection of rapid- or short-acting insulin before each meal. MDI therapy, like insulin pump therapy, mimics the natural secretion of insulin by the body experienced by people without diabetes.
MDI therapy can be performed in two ways:
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Needle and syringe: Insulin shots can be given via a needle and syringe. The dose of insulin is drawn up from the vial through the needle into the syringe and administered into the layer of fat just below the skin (the subcutaneous tissue). |
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Insulin pen: Insulin pens combine the syringe and insulin into a single unit. Some insulin pens contain a cartridge of insulin that’s inserted into the pen, while others are pre-filled and discarded after all insulin has been used. To use an insulin pen, you typically twist or snap on a new needle, dial a dose, and inject the insulin. |
Injection sites should be discussed with your healthcare team but may include the stomach, thighs, backs of arms, and buttocks.
Insulin Pump vs. MDI Therapy
When you understand the key differences between insulin pumps vs. MDI therapy and how each will affect your day-to-day diabetes management, you can work with your healthcare team to determine which is right for you.
Insulin Pump Therapy |
MDI Therapy |
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Insertion/injection frequency |
Catheters, or cannulas, need to be inserted into the skin every few days. |
Injections are needed multiple times per day. |
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Bolus insulin delivery |
Simply press a button to deliver your dose of insulin at mealtime. |
Injections are typically needed for each meal. |
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Basal insulin delivery |
Basal insulin is delivered continuously. |
Basal insulin needs to be injected at a specific time of day. |
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Glycemic control and complications |
Several studies have found that insulin pump therapy is associated with a reduced risk of short-term diabetes complications and better glycemic control compared to MDI. |
For some, MDI may not provide the necessary level of glycemic control. |
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Logistics of insulin delivery |
Insulin pumps can be disconnected only for short periods. Insulin pumps also have tubing, which can be cumbersome and can get caught on objects if it’s not kept covered. |
To use MDI therapy, simply get out your vial, needle, and syringe or insulin pen as needed. There’s no need to wear a device or deal with tubing. |
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Level of training and education |
Insulin pumps have a steeper learning curve compared to MDI and require training by a diabetes care and education specialist or endocrinologist. |
The injection process is simple and easy to learn. |
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Cost effectiveness |
A recent study found that the mean annual cost of insulin pump therapy was $3,923 more than MDI therapy. |
MDI may be more cost effective compared to insulin pump therapy. |
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Risk of device malfunctions |
Insulin pump malfunctions can increase your risk of diabetic ketoacidosis (DKA). |
While user error is still possible, MDI reduces the risk of device malfunctions. |
Monitoring Glucose Levels to Inform Treatment
Insulin pump therapy and MDI can both be effective ways to administer insulin and manage glucose levels. When considering an insulin pump vs. MDI, it ultimately comes down to what you and your healthcare team think is best for your unique diabetes management plan, lifestyle, and personal preferences.
Whether you and your healthcare team decide on an insulin pump or MDI, it’s important to discuss glucose monitoring options as well. Self-monitoring of blood glucose (SMBG) provides you and your healthcare team important insights and helps you evaluate the effectiveness of your treatment plan and inform any potential treatment adjustments. Checking your blood glucose regularly can also help you respond quickly to blood glucose changes due to factors such as diet and exercise to prevent complications and support overall physical health.
If you’re looking for a simple, fast, and discreet way to test, you may consider using an automatic blood glucose monitor (ABGM), such as the POGO Automatic® Monitor, which automatically lances and collects blood in a single step.
Ready to Have Freedom at Your Fingertip?
POGO Automatic is the only FDA-cleared blood glucose monitor that lances and collects blood automatically, in one simple step, with its 10-test cartridge technology, eliminating the need to carry separate lancets and test strips. Reach out today to learn more about how you can check your blood glucose without interrupting your day.
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Jaclyn OwensJaclyn Owens is a product director specializing in diabetes management tools. She is committed to using technology to empower people with diabetes and help them take control of their health. |
All content on this website is for educational purposes only and does not replace the guidance of your healthcare practitioner. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
