My grandson has been approved by the endocrinologist for an insulin pump. He is well controlled on twice daily injections (A1c is 5.9% with no severe hypoglycemia) but has to maintain a fairly rigid schedule. However, he has been told that he will have to go to a major medical center that’s over 200 miles away to get his pump and instruction. Is an inpatient stay normally required to convert to the pump?

How insulin pump training is provided can be quite varied and may depend on the comfort level of the medical team or reimbursement requirements of the insurance company. In the hands of experienced pediatric diabetes teams, pump training is often accomplished in the outpatient setting. Some centers still admit patients because insurance benefits are better.

Regardless of the setting, pump training should be more than just learning which button to push. It should be a comprehensive program which reviews carbohydrate counting, use of supplemental doses, sick day management, basal rate and bolus dose adjustment, troubleshooting, and skin/ site care.

BS
Additional comments from Dr. Donough O’Brien:

There is no need for initial pump instruction to be carried out as an inpatient, although it may make initial teaching easier for the staff. I have to say though that with an hemoglobin A1c of only 5.9% I wonder if a pump will be all that benefit especially as your grandson’s present endocrinologist seems disinclined to accept pump supervision and his initial instructors will be so far away.

DOB