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The DCES and Pump Therapy

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Diabetes care and education specialists play an integral role in helping device users achieve success.

Content Developed By: Katherine Krieder Evans and Dana Roseman

Tool Created and Reviewed by: ADCES Tech Committee and the danatech staff

 

Helping People Use Insulin Pump Therapy Successfully

Continuous subcutaneous insulin infusion (CSII), also known as insulin pump therapy, is in its fifth decade of use and continues to grow in popularity. More recently, there has been an integration of continuous glucose monitoring (CGM) devices onto the pump screen and the creation of the first FDA approved insulin pump that responds to sensor data to adjust basal rates, suspend on low or impending low, and give automatic correction bolus doses when glucose is approaching pre-determined targets.

Automated insulin delivery systems are revolutionizing glucose management.1,2 The current data indicate there are over one million people with diabetes on insulin pump therapy worldwide3 and 350,000 to 515,000 in the United States.4 Insulin pump therapy offers increased lifestyle flexibility and improved glucose management.

 

Role of the Diabetes Care and Education Specialist

Diabetes care and education specialists play an integral role in helping people with diabetes (PWD) achieve success in the use of insulin pump therapy, which has been demonstrated to improve clinical outcomes and quality of life.

Diabetes care and education specialists:

  • Support PWD as they consider, initiate and learn how to use an insulin pump to manage their diabetes.
  • Coordinate the plan of care between the prescriber, insulin pump manufacturer and insulin pump trainer during pump initiation and ongoing management.
  • Serve as a resource for other health care professionals and community organizations that provide support for those who use insulin pumps.
  • Serve as a resource to family members or significant others who support the person with diabetes.
  • Complete trainings and gain experience, over and above that of being a certified diabetes care & education specialist (CDCES), to be considered an expert in insulin pump therapy (i.e., CPT).
  • Obtain advanced knowledge and training in the use of CSII, carbohydrate counting as it relates to CSII, and the ability to evaluate and interpret data downloads to provide treatment recommendations.
  • Obtain certification to provide training in the use of each specific brand and model of insulin pump with which they work. This is obtained through the individual insulin pump manufacturers.

Explore our insulin pump section further to find topics that should be covered by diabetes care and education specialists when teaching people with diabetes and their families or significant others. Insulin pump therapy and the importance of maintaining a high level of expertise in this subspecialty of diabetes education if choosing to include pump and sensor training in the individual specialist’s practice are critical in diabetes management today.

References

Grouped by the claim each source supports. Primary and official sources — ADA, FDA, danatech, peer-reviewed — are tagged and listed first within each group. Compiled and verified July 2026.

2026 ADA Standards of Care & AID as preferred delivery
  1. 1. American Diabetes Association. 7. Diabetes Technology: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S150–S178. AID is the standard of care and preferred delivery method for people with type 1 diabetes who can safely use the device; rec. 7.27 supports open-source AID management advice.Primary
    Diabetes Care 2026 (Section 7)
  2. 2. American Diabetes Association. ADA Releases "Standards of Care in Diabetes—2026." Press release, Dec 2025. Confirms new guidance removing prior treatment prerequisites before initiating CSII or AID.Primary
    ADA press release
  3. 3. CGM: ADA 2026 Standards of Care. American Academy of Family Physicians. Documents Rec. 7.8a — no requirement for C-peptide, islet autoantibodies or insulin-treatment duration before CSII or AID.
    AAFP summary
What integration is — and why not every integrated pump is AID
  1. 4. Boughton CK, Hovorka R. Automated insulin delivery in adults. Review describing sensor-augmented pump therapy and low-glucose suspend / predictive low-glucose management as distinct from full AID.
    PMC6986367
  2. 5. Sensor-Augmented Insulin Pumps and Hypoglycemia Prevention in Type 1 Diabetes. Describes SAP with and without automated insulin suspension — the integration-without-full-AID category the page distinguishes.
    PMC5375081
  3. 6. Closed-Loop Insulin Delivery Versus Sensor-Augmented Pump Therapy in Older Adults With Type 1 Diabetes (ORACL). Diabetes Care. 2022;45(2):381. Contrasts closed-loop AID against SAP in "manual mode" with optional low-glucose suspend.
    Diabetes Care 2022
Meal input differs by system (including the iLet)
  1. 7. U.S. Food and Drug Administration. FDA Clears New Insulin Pump and Algorithm-Based Software (iLet). Confirms the iLet replaces conventional carb counting with a meal-announcement feature and initializes on body weight alone.Primary
    FDA press announcement
  2. 8. danatech / ADCES. FDA Approves iLet Bionic Pancreas. danatech's own coverage of the meal-announcement mechanism.danatech
    danatech news
  3. 9. Beta Bionics. Meal Announcements Guide for iLet Bionic Pancreas. Manufacturer instruction: announce the meal when eating begins, not before; do not announce if more than 30 minutes have passed; do not use to correct highs.Manufacturer
    Beta Bionics guide
Correction behavior, bolus workflow & insulin stacking
  1. 10. American Diabetes Association. 7. Diabetes Technology: Standards of Care in Diabetes—2026. (See ref. 1.) Supports individualized device selection and system-specific use rather than a single correction rule.Primary
  2. 11. Beta Bionics. Meal Announcements Guide for iLet Bionic Pancreas. (See ref. 9.) Instruction not to use meal announcements to correct a high, illustrating why correction workflow is system-specific.Manufacturer
CGM data gaps, questionable readings & confirming with a meter
  1. 12. diaTribe. Your Guide to the 2026 ADA Standards of Care. Summarizes the Standards' guidance to use a glucometer when CGM readings don't match symptoms, e.g. during warm-up periods.
    diaTribe guide
  2. 13. American Diabetes Association. 7. Diabetes Technology: Standards of Care in Diabetes—2026. (See ref. 1.) Underlying recommendation for confirmatory glucose-meter use.Primary
Insulin-delivery failure: AID cannot confirm insulin is reaching the body
  1. 14. danatech / ADCES. Troubleshooting Unexplained Hyperglycemia. danatech's own step-by-step guidance: mechanical, behavioral and metabolic causes of unexplained highs; when to check ketones; when to seek emergency care for DKA.danatech
    danatech troubleshooting
  2. 15. Howsmon DP, et al. Early Detection of Infusion Set Failure During Insulin Pump Therapy in Type 1 Diabetes. Confirms infusion-set failure can cause prolonged hyperglycemia or DKA, characterized by rising glucose despite increased insulin infusion.
    PMC5094340
  3. 16. Frequent Insulin Infusion Site Failures "a Huge Problem." Medscape, Mar 2026. Reports that a large share of AID users experience infusion-site failures; unexplained hyperglycemia can serve as a clinical proxy for undetected occlusion.
    Medscape report

Primary = official ADA, FDA, danatech or peer-reviewed source. Manufacturer = manufacturer product or labeling page.

All URLs verified accessible July 2026. Device insulin clearances and indications should be confirmed against the current IFU. The page defers current-device specifics to Find & Compare, so no device-model citations are listed here.

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DISCLAIMERS: 

This site and its services do not constitute the practice of medical advice, diagnosis or treatment. Always talk to your diabetes care and education specialist or health care provider for diagnosis and treatment, including your specific medical needs. If you have or suspect that you have a medical problem or condition, please contact a qualified health care professional immediately. To find a diabetes care and education specialist near you, visit the ADCES finder tool.

ADCES and danatech curate product specifics and periodically review them for accuracy and relevance. As a result, the information may or may not be the most recent. We recommend visiting the manufacturer's website for the latest details if you have any questions.

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