Working for a pump?

Has anyone ever been told that they had to (Work for a pump)??

My son is 4 and we have yet to get an endocronologist. He is recently diagnosed... and there are only 3 here that we cld use.

Yet one of them we were told is great and she works with our diabetes educator. In fact she allows our educator to make the call as to when he wld be able to get one.. Yet then she tells us the other 2 docs arent so great.. In fact they make u work for one.. What does that even mean?? How does a 4 yr old work for one?? I dont get it... so now im praying that we cld get in with the one she likes... Ugh,.... Please keep us in ur prayers.. If in fact it comes to him requiring a pump .. i wld like him to be able to have one without any bull...

My daughter (8 years old) is seen by a large group of pediatric endocrinologists, probably about 15 doctors in all. Even though they are all in the same practice, they each have their own criteria they use when deciding when a child can go on a pump.  When she was diagnosed (Oct '09) we tried out a few doctors before we found one we were comfortable with.  I think our endo was the 3rd doctor we saw and I knew that she was the one I wanted to stick with. She (our endo) was willing to put a child on a pump at any time so long as the parents (and child if age appropriate) showed that they understood the concept of a pump and what the benefits of it were. I know other docs in the group required the child to be out of the honeymoon phase, or have done the injections for a year, etc before okaying the pump.  I have even heard of some endos that require a certain a1c before allowing it.

My arguments to all that is: there is research that shows that using a pump will prolong the honeymoon period, which is mostly a good thing, doing injections for a month is adequate enough for most people to become comfortable with actually injecting as well as getting used to doing the math calculations and a pump can dramatically reduce the a1c level so why not start it as soon as possible.

My suggestion to you is that you go to your endo appointment fully educated about what a pump can, and can't, do for your child.  Read up on some of the research that shows the benefits of a pump and don't be afraid to share what you know with your endo.  Be diligent in checking your child's blood sugars and recording them to show your endo you are serious about good management of the disease.  If your endo flat out refuses because his or her policy is a certain way, and you don't agree with that for your child, look for another endo.

Good luck! I hope that if you feel a pump is best for your son, you get one soon. My daughter really likes hers and I can't imagine going back to injections. Some kids and adults, though, prefer injections over a pump. Everyone is different and their diabetes care should be tailored to fit them.

Not sure, but my guess is that "working for a pump" means that your son's blood sugar is tested frequently and you know how to carb count and know his insulin correction factor.   

Before meeting with endo I really recommend you get "Pumping Insulin" by John Walsh.  Your library may have it;  Amazon definitely has it.

The book has great information to help you understand if a pump makes sense for your son and if you're ready to deal with the extra work and cost of it.  It's also a great overview of pump therapy and will help your endo see how serious you are about trying a pump. 

One more thought -- it's usually hardest to get in with a practice as a new patient, so you might not get the endo you want for the first visit. But. afterward, he'll be a returning patient, so it should be much easier to switch to the other endo as a follow-up. You could always ask for an earlier follow up if you feel you didn't get the info you were hoping for.

BlessedMom's reply is wonderful. I would also add that a pump allows much smaller and more accurate dosing than can be done with syringes. This was the PRIMARY reason we put our 4yr old on a pump. We were having a heck of a time avoiding lows because you really can't give 0.25 units with a syringe and his basal insulin was also 1.0 unit of Levemir - he needed TINY amounts of insulin, which we were able to give with the pump. If you are having any problems with having post meal highs because you are rounding down a lot or if your son is on small amounts of basal and still having lows, these are reasons to look into pumping (in my non-medical opinion.)

However, our clinic did require that we complete several pump training classes (they were free, just had to register and attend them) and also fax in BG records before they approved our pump request. But their attitude is that if you want the pump, they will help you get it. If going to classes is all they mean by work for it, then I would agree with that amount of 'work'. However, as Blessed said, if you start on MDI with carb counting, there is not much to learn for the pump. If your child starts on a fixed carb plan and NPH, etc. then there is more work to do.

Thanks u to everyone for all the great info.. My son has his first apt set and we did get the endo I wanted. Im so hoping it all works out well.. as he is my life and I will do anything to help him and make his new life an awesome one..

This is just stupid I see it all the time from people and had the same problem when I wanted a pump like I tell everyone go directly to the pump manufactures and they will send you to a doctor they work directly with.

As a health care professional and a diabetic for 27 years, I think I may be able to clarify what the educator was trying to say.  Pumping is not easy.  I went from standard therapy to multiple injection therapy to pumping over the course of 11 years because I transitioned as those therapies became available.  Slowly, I learned about carb counting, how my body specifically reacted to different foods and different activities, and how to correct for highs.  I was one of the first adolescents to be started on a pump (at the time they did not think teenagers could handle pumping).  Now that pumping is available for everyone, I think some providers are concerned that newly diagnosed diabetics are not getting the training that I got over 11 years to prepare me for the pump.  The work that she is talking about is important.  It will mean that your son will live a long and healthy life.  It also means that you and your son will have to work as a team to figure out what works best for him. 

Whether the doctors are "good" or not, I think there are a few important things you should bring up in your conversation with them.  First, research the benefits of pump therapy (there are many), and discuss with the doctor that you want those benefits for your son.  Second, work with the educator to count carbohydrates, test throughout the day (not just at meals), and keep careful track of food, activity, and insulin use.  This will show the doctor that you are serious about maintaining control and will do everything that it takes to make pumping worth your time and his.  Third, see if the educator knows of some kids near your child's age that are pumping now.  Many parents are willing to share their experiences (good and bad) with the pump, and they will be able to give you advice.  You may also find parents whose children go to the same endocrinologist, and you can talk to them about how they started the pump conversation. 

Both as a health care professional and as a person who has had diabetes and a pump for many, many years, I highly recommend that you do everything you can to get your child on the pump.  Armed with some good information about pumping, I think you will be able to convince any doctor that pumping is best for your son.  Good luck. 


First of all, I think that your doctor needs to get a clue. Working for a pump? That is just ridiculous. You and your child work every single day to stay healthy. If you want your son to have a pump no doctor should tell you that you have to work for it. My opinion is to go to a different Endo, one that has a clue. IMHO every child should be on a pump to make their lives so much easier. Why would they deny you that? Get a doctor you are comfortable with it will make all the difference in the world!


I wasn't there and don't know the exact context, but I think I'm more with Heidi.  I may be all wet on this since I don't have a pump myself but am familiar with the concepts from my own research and from being on here. If you don't even have an endocrinologist yet, then perhaps you should slow down a little.  Learn about diabetes and insulin and diets and how it all works first.  Being on pump makes some things easier, but it takes more close attention to your blood sugar and diet.  People on the pump have to test a lot more and then base their dose off of a lot of variables. 

If you hear that this person is a good educator then perhaps they are.  Roll with it for a while.  Once you understand the disease and how it works better, you'll be in better position to make an informed decision.