Multiple Daily Injections (MDI) is the first line of diabetes treatment in Europe. It is defined as: the administration of 3/more insulin injections/day. This includes one injection of long-acting insulin (24h hours active) in the evening and an injection of rapid or short-acting insulin before each meal.
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 level 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 digestion of most meals.