People with insulin-dependent diabetes (type 1 or type 2) need to take insulin every day to keep their blood sugar levels in check. Without that insulin, the cells in their body can’t use blood sugar for energy, so the sugar builds up in the blood stream causing damage to the blood vessels, nerves, and kidneys. The disease can also cause fatigue, poor wound healing, and other complications from not being able to metabolize energy from the food they eat.

Diabetics have two options for insulin delivery: manual injection and the insulin pump.

Manual Injection

Manual injection is the oldest and most well-known method for taking insulin. Depending on the treatment protocol, the patient injects insulin at least twice a day based on his blood sugar readings. For example, the multiple dose insulin therapy (MDI) protocol has the patient inject what’s called a basal dose of long-acting insulin up to twice per day, and inject doses of fast-acting insulin, called a bolus, during meal times. MDI is just one of several possible insulin regimens available to diabetic patients.

Insulin Pumps

The insulin pump is a much newer method for taking insulin. The first pumps were introduced in 1978, but due to their large, clunky size, they didn’t really take off until much later. The insulin pump is designed to function like an automated MDI. The device injects the basal dose once an hour over a 24 hour period, and you can also set it to inject a bolus during meal times.

Manual vs. Pump

Ease of Use

Insulin injections are fairly easy to do because the process has changed little since the first insulin injection was invented in 1921. In fact, with the advent of diabetic pens, it has become even easier to select and administer the dosage.

On the other hand, insulin pumps have a fairly steep learning curve because patients have to learn how to program and adjust the pump. Also, they have to work closely with their doctors when they first get the pump, to track their blood sugar levels and find the right hourly basal dose.


Manual injections are generally cheaper. Sure, the costs can add up, but the supplies are also so ubiquitous that you can often find good prices on diabetic strips, and other items, from a variety of retailers. Additionally, many of these supplies are covered by insurance, and some drug stores even have diabetes care programs that offer discounts and injection supplies.

Insulin pumps can be expensive. The pumps alone can cost between $4,500 and $6,500, which you will have to pay out of pocket if your insurance does not cover it. The pumps require special part like flexible needles, infusion lines, tape, and batteries, which can add up to $1,500 per year in supply costs depending on how much your insurance will cover. Also, you will still need to take regular blood sugar readings, so you will need those supplies as well.


Insulin pumps are much more convenient than manual injections. With the pump, almost everything you need is in the device and it’s administered automatically. If you need extra, you can get it with the push of a button. The only thing you would need to carry with you are the supplies you need to do your blood sugar readings, which can all fit in a small pouch.

With manual injections you need to carry your insulin, syringes, and all of the glucose meter supplies with you wherever you go. To give yourself insulin, you need to find a private spot and go through a series of steps, including drawing the dose into the syringe, which can be time consuming. Dosing pens are easier, but they can still be time consuming.

Blood Sugar Management

Both insulin pumps and manual injections have their strengths and weaknesses when it comes to blood sugar management. Pumps have a greater risk of dangerously high blood sugar —  especially if you disconnect from the pump for long periods — and manual injections have a greater risk of dangerously low blood sugar.

However, if patients monitor their blood sugar regularly, comply with their treatment protocol, and work with their diabetes treatment team, either method can be effective for blood sugar management.