# MDI's



## MrsBoyle (Aug 15, 2010)

How do these work as at the moment Dylan is only on 2 injections a day.
But we are looking at changing to still not 100% with the pump as im not sure how he will be as he wont wear a plaster 

So looking for info on the MDI.
x


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## aymes (Aug 15, 2010)

MDI works on the principle of two different insulins, basal and bolus.

The basal insulin (lantus or levemir usually) is sometimes known as your background insulin and is taken once or twice daily (depending on how long it 'lasts' in an individual etc). The basal insulin should deal with the background level of glucose the liver gives off, so the theory being that if the basal dose is right your levels should stay steady without eating/unusual exercise. However, not everyone finds they have a steady need for the same level of basal all day so there may be fluctuations, to varying degrees and this to me is the key advantage of a pump in that you can have different basals throughout the day as mdi only gives you the chance to change it on your once or twice daily injection.
The bolus element of the regieme is there to deal with your intake of carbs. To do this you need two things; to know the carb content of the food and your insulin to carb ratio. Carb counting seems extremely daunting at first but it does become second nature very quickly. In some areas you may be able to go on a course to learn, or if not you should be able to have some sessions with a dietician. The insulin to carb ratio is in many ways trial and error, although there are sone calculations based on weight etc that can be a starting point. Many people need different ratios at different times of the day, in most cases (not all), insulin resistance is higher in the morning so more insulin may be required per gram of carb. With the above worked out it's then a case of injecting everytime you're eating carbs, including snacks if applicable!
On the surface mdi does seem extremely complicated but in reality it does become quite natural quite quickly. Good luck if you do choose to try it!


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## Monica (Aug 15, 2010)

Aymes said it all 

Just to show you what Aymes means with different ratios, I'll put down C's ratios.

Breakfast        2u/10g carbs
Lunch           1 1/2u/10g carbs
Dinner/Tea    1 1/2u/10g carbs

Any snacks she might have during the day (which she rarely does) she'll have 1 1/2u/10g carbs, but at bedtime she needs slightly more 1 3/4u/10g carbs.

Obvously those ratios only apply to C. Dylan probably will need less as he's only little.


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