Whether you have been controlling your diabetes with multiple daily injections or an insulin pump, if your therapy is not delivering what you hoped it could, it is always a good idea to speak with your healthcare provider. The following questions are meant to make that discussion as productive and easy as possible, whether it is your primary care physician, endocrinologist or diabetes educator. Simply bring them with you to your next appointment to share your questions or concerns with your provider.

My satisfaction with my current glycemic control is:

Very Dissatisfied — I struggle to stay in my target range.
Somewhat Dissatisfied – I have several readings per week outside my target range.
Somewhat Satisfied — I have a few readings per week outside my target range.
Very Satisfied — I usually stay in my target range.

My concern(s) with insulin pump therapy is (check all that apply):

I’m afraid a pump with tubing will be difficult to learn and use daily.
I don’t want to have a device hanging off my belt.
I don’t want to be connected to tubing.
I’m afraid I won’t be able to control my glucose.
I am too active to have a pump attached to me.
A pump is too bulky.
A pump makes it noticeable to others that I have diabetes.
I can’t swim with a pump on.
There are too many parts to keep track of.

I would like to use the OmniPod® Insulin Management System because (check all that apply):

It will enable me more control.
It has no tubing.
Its design offers safe and reliable insulin delivery.
I will not have to disconnect my pump for routine activities like bathing, exercise or swimming.
There’s flexibility to rotate insertion sites.
It has virtually pain-free automatic cannula insertion, with no visible needles.
It has an integrated blood glucose monitor.
It is easy to use.

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