@LarissaW I am certainly not telling anyone to do or not do IV or IM injections. That’s definitely a personal choice. Like with many choices I make, I evaluated risks and benefits and probabilities. When I initially decided to do IV I also asked myself about paranoia factors the medical community was pushing and considered how often I hear of an IV drug user getting a blood infection, taking into account that they are using dirty needles in a crackhouse or a filthy back alley.
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@Dc53705 @Nickyghaleb - ya I was more asking out of curiosity to see if IM could be another tool in my diabetic tool kit. I just don’t see a lot of benefit out of IV for myself since FIASP already kicks in in 5-15 minutes via pump site. A lot of my highs come at night and I don’t trust a drowsy me trying to navigate IV at all. IM sounds way more manageable. I’ll be interested to try it with FIASP to see if there are any differences between IM, pump, and subQ injections
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I use Fiasp, and with regular pump boluses or injections I find it starts to work in about 15 minutes (that’s when I see direction change on my CGM) and is out of my system by about three hours.
With IM, as others have said, I find them very inconsistent. But when I’ve had an IM shot with Fiasp work, it seems to work and be out of my system twice as quickly. I’d use it more often if I could get it to consistently work.
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Good to know, thanks!! I’ll see how IM goes for me and if I can figure out how to get consistency with FIASP IM if I like it
A few decades ago I used to inject into a vein on the back of my hand. I think I was on a study where we or someone drew a sample out of the same spot. I figured if I could take blood out I could put insulin in. It was never a lot and was pretty quick. I would do this if BG was really high and I had a bike ride that morning and no time to let the BG drift down.Worked great. Used elastic material as a tourniquet and injected with an insulin syringe. Just haven’t had to do that since pumps and sensors came along.
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Hope I didn’t come across like I was encouraging you to try it, @LarissaW. I’ve got no desire to do that whatsoever. I like it for myself—at this stage. It gives me a mental boost I can’t get with the other bolus options. For now, that’s something worth any extra work it might require. I also have never had the chance to try Fiasp or Afrezza. I’m going to inquire though… Since I’ve really grown accustomed to the timing of the various shots, it would be interesting to see how they line up against them. My endo thinks I’m nuts anyway, so I’ll see what she’s willing to share.
I hope you’ll share whatever you find with your Fiasp travels. 
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Thanks for clarifying, @Dc53705. I do understand about it being closer to the skin. All good information. Thanks!
Hello @FUsniglet19. Welcome! 
It was interesting reading your timeline… as it seems we’ve moved in opposite directions. You went from injections to the pump, and I’ve gone from pump only to injections. Now much of this is still new to me, but in general, I can’t get a pump bolus to come close to the speed of IM or IV (assuming I did it right). Are you able to bolus just a standard bolus?? Or maybe you’ve learned some kind of trick?? I was using temp basals and extended boluses to give a little kick to my bolus, but it still felt pretty slow in comparison. What pump do you use?
Nothing has ever been as fast as iv insulin for me. Now on a hybrid
closed loop system and I and a fellow user can’t believe how slow
insulin acts. What we need is something much faster. Since current
system is way too gentle I fake it and dial in carbohydrates I don’t
intend to eat. Still slow but better than the system dawdling along.
What I do like is the consistency overnight. BG is kept very steady
and I feel like I am safe. Had to go without it for just one night
and it was horrible. Subcu delivery is certainly not physiologic in
timing. Either better, faster insulin or better delivery site would
help. Speaking of slow…how about the length of time it takes to
raise blood sugar while your pump screams at you to eat more, more,
more?
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Almost the exact same for me… but in the opposite direction. 
The Guardian was messing with my emotional well being.
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670G by any chance? Can’t think of anything else you could be faking to get some insulin.
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You got it. Can be an annoying system but there should be better
models in the future. Someone said it’s like wearing a toddler on
your belt. Always wants attention and has many alarms which luckily
you can shut off.
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Why not try using Auto mode while overnight only, when it is useful and can save you from a low in your sleep. Then turn Auto mode off when you wake up and use it as a traditional pump until you’re ready to go to bed again.
BTW, I have no interest in trying IV injections, and I suspect there are many out there that are in that camp.The potential downsides just seem too large compared to any relatively minor increase in BG reduction speed. Risk reward just doesn’t justify it to me.
I have done IM with mixed results as others have suggested.; sometimes they seem to be quicker but other times not. But Fiasp had no discernable benefits to me for corrections, so I gave up on it and have gone back to Humalog only. Have not had the chance to try Afrezza.
I was interested in this possibility since I believe the Medtronic pump would be the most accessible to me. But when I posted about it in @Nickyghaleb’s group, I’m fairly sure people said it couldn’t be used that way for whatever reason. I could be remembering incorrectly, though, so maybe she will chime in if I’m wrong.
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Automode can certainly be turned on for just overnight and turned off during the day. I did this a bit, with it being successful only sometimes. It’s all personal, but it ran me higher than I’d like (around 140-160), and then you have the component of getting guardian sensors to play nice (last their full 7 days) and actually be accurate enough to be trustworthy. Mainly though, I stopped using AM for night because once I put the dexcom g6 on I realized how demanding and for me, taxing, maintaining the guardian sensors (and AM) was. Cost:benefit analysis for me - not worth it, but I’ve certainly heard of others using AM just overnight and loving it!
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I suggested this to NG also, but don’t think she ever tried it, since she had also already made the decision to move onto a different platform. She did show an overnight log where it looked like AM did save her from a probable low. But if you don’t have the option of another alternative (like it sounds is the case for you Jen), then it is certainly worth investigating to see if it would be helpful for you.
Unfortunately, even the Medtronic pump has serious accessibility issues (having to press a different button every time the screen is unlocked…Tandem wins in that regard, although Tandem’s entire pump interface is entirely inaccessible, so, heh). It’s too bad that every pump has features that I have huge reservations about, so in the end, I’m just going to have to pick one and stick with it. Given that I’m already using Dexcom, and that being able to use sensors for a month is important to me (since I don’t have any CGM coverage), it will probably be the t:slim, and I’ll probably put little tactile pumps on the screen protector to make using it a easier. Currently there’s an annoying hold-up due to my insurance company policies and provincial coverage specific to the t:slim. So I’m just waiting for that to be resolved (as are many others!) as well as for the app to be released, which should be soon apparently. If I like the app that will confirm my decision to go forward.
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I can’t imagine there could be worse, so maybe.
It was not a good pump for me. And hearing them boast of the next model being able to predict a low up to 4 hours prior to its occurring is not helping me trust they’ll do any better. Maybe they’ll pull it off though. It would be nice if they do.
I think I see down below where @LarissaW is already saying this, but it can be used like that. However, it’s not as simple a solution as it might seem on the surface. Because it’s a “dynamic delivery”, every night can be different. Because every night can be different, you will never know exactly how much insulin you’ve received without adding up your micros or running a report. Kind of a daunting task at 6:00 am when you’re trying to figure out what to bolus for your coffee. (I might be projecting here— not sure.)
Anyway, it takes whatever certainty we do have out of our morning insulin dosing. I did this for about 6 months, and it was a much better solution than to remain in Auto 24 hours a day, but it was not as good a solution as just staying back in Manual Mode and letting the pump suspend. Even that could lead to some zingers, but it is at least possible to wake up and get a tangible number to apply to what you’ve received over the last few hours.
I did, for maybe 2 months, get up at 4:30 in the morning to drop out of Auto Mode. I did this with an actual “get out of bed” time of 6:15. So I’d turn it off and go back to sleep. It meant that for the last 2 hours of the morning I would get my full insulin… and then mornings were mine again. That was great… until I wasn’t willing to pre-wake anymore.
That’s the long response for this shorter answer: it’s possible but may or may not be worth it. You can always revert back to Manual with SmartGuard suspends to help you with your overnights though. It’s also very beneficial with a little more predictability.
I really hope you actually wanted me to say something.
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Agree with everything you said. I’d just add to this that, for me, it wasn’t just that it could run me a little higher than I’d like, but that it could set me up for a ridiculous high mid-morning. As soon as I had that coffee, no matter if I added extra insulin to try to head it off, on top of such a reduced rate over night, my blood sugar would push up to 250-350… Even in Manual Mode doing corrections left and right, I could spend hours trying to get that sucker to return to earth. Again, I was willing to just do it for a while until I finally realized how cool things were back in Manual. Yes, more lows. It took some serious adjustments to get those back under control after returning to Manual, but I made the adjustment for the most part. I can’t even remember anymore. Now I’m using Basal-IQ, and it’s doing what I think the 670G was trying to do. I hope Medtronic has taken notes.
@jag1, assuming I’m NG, actually, that’s not right. You suggested it to me long after I had already ruled it out in my own management. We talked a bit about what you thought it could do, some of which I agreed with, and about why it turned out, in my experience, to be trickier than that. As you had never used it at that time, it was really only my experience we were debating, and my experience left absolutely no doubt in my mind. I did it for 6 months. Manual Mode with SmartGuard Suspends is a better option for me, and Basal-IQ is a far better option than that. We’re all different though. It’s just taken some trials before finding something that is a good fit for my diabetes.
I have months of logs, many of which I’ve shared. I can’t be sure to which you are referring. However, I know what I was doing with those logs, and I wasn’t using them to show how brilliant the overnight was, even though it could definitely be that. I was trying to help people understand what was happening to their numbers as they got out of bed. I’m about 99% sure that what I was showing with that log was how I hadn’t gotten much insulin overnight. I guess, in a reclined position, not eating or drinking, that reduction looks great as the night moves along. But the fallout upon rising can be ugly. That’s what I was trying to show. There are 670G users everywhere trying to figure out what has happened to cause their DP to intensify so significantly and so suddenly, even after having the same patterns for 15, 20– 30 years… It’s diabetes, and, in truth, there’s no one size fits all answers to any of our numbers, but I wanted to encourage people to ask themselves whether they saw any of these differences before beginning Auto, and, if not, to consider Auto as another possible cause.
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