HF 7948

Insulin Pump Therapy Requirements

If you or your family member is thinking about using an insulin pump, it is helpful to know what is required first. We want you to be well informed while exploring insulin pump therapy. Understanding the pump and using it safely to improve your diabetes self-management is our main concern.

You will need to work with your health care team and insurance company to help decide if you are ready for a pump. Your insurance company may have other rules for using a pump.

All Pumps Require Attention

Insulin pumps have many benefits, but they require a lot of monitoring to make sure the pump is working and to tell the pump when you are eating or having a high blood sugar. People using pumps need support and close monitoring by their diabetes team.

Strategies for Success

The following strategies are needed to have the most success when wearing an insulin pump:

  • Wear the device nearly all of the time.

  • Wear a compatible CGM.

  • Tell the system when eating a meal or snack.

  • Tell the system about high blood sugars.

  • Prepare for physical activity.

  • Closely monitor sugar levels for any signs that the pump isn’t working.

Insurance Coverage

Check with your insurance to verify coverage of insulin pumps. Insurance coverage varies. Most insurances cover at least some insulin pumps and supplies. Typically, plans cover a new pump every 4-5 years. Some plans may have an amount of time that you need to be diagnosed with diabetes before they cover a pump (sometimes as long as 6 months). You will need to be using a CGM or monitoring your blood sugars and injecting insulin at least 3 times per day.

Medicare may require proof that you do not make enough insulin to manage your blood sugars. This means you will need lab work done, including a fasting glucose and C-peptide.

Learning More

Talk with your diabetes team to learn more. You will need to learn more about the pump choices, how they work, and the process for starting on a pump. You will need to be able to carbohydrate count, use an insulin to carb ratio or carb estimate. (You may be required to meet with a registered dietitian for review).

You will also need to know your pump safety measures. This includes:

  • Explaining the steps to manage high blood sugars

  • Explaining your back up plan if the pump fails

Getting Started

After you choose a pump, let your provider know. You should contact the pump company directly via phone or website to get started. Based on the type of pump and your insurance, your pump may be ordered through the pump company, a medical supply company, or through a pharmacy. It may take a few weeks for insurance to approve your pump.

Contact the clinic to get a prescription for insulin vials, ketone strips, and glucagon.

Insulin Pump Training

A certified insulin pump trainer will contact you to schedule training. (This is not done by clinic staff.) The trainer will receive your pump orders from your provider. Before you meet with the trainer, review the materials that come with the pump.

Changes in pump settings may be needed in the first few weeks. You will need to upload or link your pump to the clinic for your provider to review. Changes will be based on your blood sugar goals. Call the diabetes team if you have high or low blood sugars.

After Getting Started

Schedule a clinic visit 4-6 weeks after starting your pump. You need to meet with a diabetes care and education specialist to review pump settings, a back-up plan, and how things are going. You will discuss common concerns such as:

  • How to prevent and treat high and low blood sugar levels

  • Sick day guidelines

  • Advanced features of the pump

  • Traveling with a pump

  • Pump failure

  • Pump supplies renewal

  • Infusion sets

  • Infusion sites

  • Taping issues

Plan to follow up with your diabetes team every 3-6 months. Visits will be designed to meet your needs.

Between these visits, do the following:

  • Call the clinic with blood sugar concerns (frequently less than 70 or more than 250).

  • Know your pump failure back up plan and how to problem-solve high blood sugars.

  • Know how/where to get your pump supplies. Contact the supplier directly if there is a question.