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Multiple Daily Injections (MDI) is typically the first line of treatment in Australia and is defined as the administration of three or more insulin injections per day. This includes one injection of long-acting insulin in the evening and an injection of rapid or short-acting insulin before each meal.

Long-acting insulins do not have a pronounced peak effect as they are designed to replace physiologic basal insulin secretion. They are designed to dissipate slowly and evenly into the bloodstream for approximately 24 hours following administration.

On this regimen, the physiologic replacement of mealtime insulin secretion is administered three times a day using rapid or short-acting insulin. These injections are given before meals and are typically adjusted to match food intake using an insulin-to-carbohydrate ratio. 

When compared to regular insulin, rapid-acting insulin is typically preferred because it provides better physiologic insulin coverage for meals and more closely matches the glucose rise that occurs in response to meals. The peak action time of rapid-acting insulin occurs at approximately 1-1.5 hours after administration. This correlates well with the digestive time of most meals.

Alternatives to MDI

MiniMed® 770G adapts to your patient's unique needs

When it comes to your patient's insulin needs, no two days, or nights, are the same. Basal insulin requirements are as unique as each of your patient's are. 

The MiniMed® 770G system^ was designed with this in mind. It is the only available insulin pump with a dynamic algorithm. It is not based on a pre-defined, pre-set basal rate so it makes no assumptions about what your patient needs or when they need it. It automatically adjusts basal insulin based on their individual body, every day.1,2


  • Even though long acting insulins are designed to last 24 hours without a pronounced peak, it does not last this long in many individuals, and in others may last longer
  • Some patients must divide their long acting insulin into two injections, with half of the dose administered in the morning and the other half administered in the evening
  • The acidic pH of long acting insulin can result in a slight burning sensation when it is administered.

^Components sold separately. Automated insulin delivery is made possible through combining Medtronic insulin pump and continuous glucose monitoring technology.
1. Bergenstal, R. M. et al. Jama. 2016; 316(13): 1408-1408

2. Garg SK et al. Diabetes Technol Ther. 2017 Mar:19(3):155-163