Type 1 diabetes treatment options: insulin therapy, pumps, and beyond

There are several ways to manage type 1 diabetes, all centered around delivering insulin and monitoring glucose levels. These approaches differ in how insulin is delivered, how much automation is involved, and how they fit into daily life.

Multiple daily injections

Multiple daily injections (MDI) are a common way to manage type 1 diabetes using insulin delivered by syringe or pen. This approach typically combines long-acting (basal) insulin to support your body between meals and overnight, with rapid-acting (bolus) insulin taken at mealtimes or to correct high blood sugar.

MDI is often the starting point after diagnosis and can be an effective long-term option. While it offers flexibility without requiring a device, it does rely on manual dose calculations and multiple injections throughout the day.

Insulin pump therapy

Insulin pumps deliver insulin continuously through a wearable device, helping replace the need for multiple daily injections. Instead of separate basal injections, pumps provide small, steady doses of insulin throughout the day, with additional doses given as needed for meals or corrections.

There are two main types of insulin pumps:

• Tubed pumps, which connect the device to the body through thin tubing
• Tubeless pumps, which are worn directly on the body without external tubing

Both approaches are designed to support more precise insulin delivery. The differences typically relate to how the device is worn and how it fits into day-to-day activities.

Continuous glucose monitoring (CGM)

Continuous glucose monitoring provides real-time insights into glucose levels throughout the day and night. A sensor is worn on the body that tracks glucose trends and sends updates to a receiver or smartphone.

CGM can be used alongside any insulin delivery method, including MDI or pump therapy. It helps inform day-to-day decisions by showing how glucose levels respond to food, activity, and insulin, and can provide alerts when levels are trending high or low.

Today, CGM is widely considered a foundational part of managing type 1 diabetes.

Automated insulin delivery (AID) systems

Automated insulin delivery (AID) systems bring together an insulin pump and a CGM to adjust insulin delivery in real time. Using glucose data from the CGM, these systems automatically increase, decrease, or pause insulin delivery to help keep glucose levels within a target range.

Different AID systems are available, each with their own features and compatibility requirements. While AID systems still require user input, they can reduce the number of decisions needed throughout the day.

Combining tools: how these options work together

Type 1 diabetes management is often built from a combination of tools rather than a single approach. Insulin delivery (through injections or a pump) works alongside glucose monitoring, and in some cases, these technologies are integrated.

Each combination offers a different balance of control, flexibility, and support. The best fit depends on individual preferences, daily routines, and comfort with different types of technology.

There is no single “best” treatment approach for type 1 diabetes. The right option depends on your individual needs, preferences, and circumstances.

Factors to consider include:

• Lifestyle and daily routine
• Age and activity level
• Comfort with technology
• Experience with injections
• Insurance coverage and cost

All treatment decisions should be made in collaboration with your diabetes care team.

Questions to ask your diabetes care team

Consider asking your healthcare provider the following questions when discussing what treatment looks like for you:

• What treatment options are available to me right now?
• How might each option fit into my daily routine?
• What are the benefits and limitations of each approach?
• How could a pump or AID system change my management?
• What training or support would I need?
• How does insurance coverage vary across options?