Where do you find good training? If your pump is prescribed by a doctor whose clinic has a formal pump-training program with qualified health-care professionals, it probably isn’t a problem. Like Joslin or Indiana University, training protocols are likely to have been formulated.
If not? The AADE suggests asking your pump company if it knows of a clinic or a certified diabetes educator who offers pump training in your area. Chalmers points out that pump trainers can be nurses, dietitians, exercise physiologists, pharmacists, or any other medical professional eligible to take the certified diabetes educator exam. (Those eligible include clinical psychologists, occupational therapists, optometrists, physical therapists, physicians [MD or DO], physician assistants, and podiatrists, as well as anyone with a master’s degree in the area of nutrition, social work, exercise physiology, health education, or certain areas of study in public health.)
You can also get some names from an online support group such as www.insulin-pumpers.org even before you begin pumping. Ask the membership if anybody in your area knows of a good pump training program. With 4,600 members in this group, an experienced pump user is sure to live in your area and know of somebody you can go to for training. The Web site also has a list of “pump docs” recommended by members.
Pump companies also offer some training, but the quality of training can vary, and a Certified Pump Trainer (CPT) designation could mean nothing more than “this person is certified as knowing how to operate this pump.” The person may not know much about controlling diabetes.
The American Association of Clinical Endocrinologists is working to increase the number of pump-savvy health-care providers through a postgraduate course in intensified insulin therapy. “We need more physicians with a knowledge base for prescribing dosages for the pump,” says Lois Jovanovic, MD, medical director of the Sansum Medical Research Foundation in Santa Barbara, California. “There are so many variables involved in getting dosages right and making it safe. You can be in terrible control on a pump if you don’t know how basals change or how to compensate for increased needs or decreased needs.”
In the meantime, make sure you don’t end up in terrible control by using the information in this article to create a list of questions for potential pump trainers. Interview them to see if they offer all the services you need, from instruction on simply operating the pump to help with setting basal rates and bolus doses, figuring out insulin-to-carbohydrate ratios, and more. There is good pump training out there, so don’t settle for less.