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Insulin Pump Therapy

Basal Insulin Differences

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As a reminder, basal insulin covers the glucose the liver makes throughout the day (in between meals) and overnight. People with Type 1 diabetes must always have basal insulin to avoid developing DKA.

The main differences in how the pump delivers basal insulin compared to MDI are:

  1. With MDI, basal insulin is delivered as intermediate or long-acting insulin through an insulin pen or syringe, injected 1-2 times a day. In insulin pump therapy, basal insulin is delivered using only rapid-acting insulin through a cannula under the skin in tiny amounts every few minutes (the pump does not use intermediate- or long-acting insulin).
  2. Basal insulin is reported as “units per hour” in insulin pump therapy. For example, 0.7 units/hr. These doses are called “basal rates”. Different doses can be programmed for different hours of the day to meet individual needs.
  3. Basal insulin delivery in pumps can be temporarily decreased or increased for a few hours. This can make it easier to prevent low blood sugars during planned exercise or high blood sugars during illness. This temporary change in basal insulin delivery is not possible with intermediate or long acting insulin.
  4. Setting and adjusting basal insulin doses in pump therapy requires a lot more work than adjusting basal insulin in MDI. This requires users to skip meals and/or snacks, or follow a set meal plan for a short time to carry out basal rate assessments.​​​