Diabetes Knowledge

Insulin pen therapy

Multiple Daily Injections (MDI)

In the case of this therapy the insulin is injected with an insulin pen at least four times each day. Two types of insulin are used here:

  • A long-acting insulin (basal insulin or delayed-action insulin) is injected once or twice each day in order to meet the body's basic requirements.
  • A short-acting insulin (bolus insulin) is injected at each mealtime and in order to correct elevated blood glucose values.

An insulin pen looks like a large ballpoint pen and contains an insulin cartridge and a dosing device. Two different pens are used for the basal and bolus insulin.

The insulin is injected into the subcutaneous fatty tissue under the skin on the abdomen, thighs or buttocks. The pen needles in use are extremely narrow, which means that insertion is barely noticeable. The pen needle is replaced after each injection.

Multiple Daily Injections (MDI) is the standard therapy for most people with type 1 diabetes. However, it does have its limits:

  • Blood glucose values may be too high when you wake up in the morning (the "dawn phenomenon"). This is caused by changes in your insulin requirements during the night, which are unable to be adequately covered with delayed-action insulin.
  • Delayed-action insulin provides limited flexibility. If your insulin requirements change suddenly, for example during athletic activity or in stressful situations, your body is unable to respond to these changes quickly.
  • It is difficult to manage irregular daily routines and shift work with delayed-action insulin because your insulin requirements are constantly fluctuating.
  • In the case of children and adolescents as well as pregnant women MDI is often unable to provide adequate control of blood glucose levels due to hormonal fluctuations.

An insulin pump is a good alternative in these cases.

Insulin release

Insulin "release" with conventional therapy compared with insulin release in non-diabetics.

Insulin release in non-diabetics

Insulin release in non-diabetics
Insulinfreisetzung bei Nichtdiabetiker Insulin release in non-diabetics
Mahlzeit Mealtime
Basalinsulin Basal insulin
Bolusinsulin Mealtime insulin (bolus insulin)

Insulin "release" in the case of MDI

Insulin "release" in the case of MDI
Insulinfreisetzung bei Nichtdiabetiker Insulin release in non-diabetics
Mahlzeit Mealtime
Basalinsulin Basal insulin
Bolusinsulin Mealtime insulin (bolus insulin)
Basalinsulin Long-acting insulin (basal insulin)
Bolusinsulin Short-acting insulin (bolus insulin)