Since going on the pump, I have been known to tinker with the basal rates a bit....raising the basal here, lowering it there. However, everything else (carb ratio, correction, insulin duration, etc.) was always set by our doctor. If you asked me how I liked the pump, I would say: 1) I love it for the flexibility -- bolusing without having to pull out a needle, ability to do a temp basal, etc. 2) However, I don't feel his blood sugar readings are much better than when on injections. So, with that said, after not being happy with the settings and feeling like something was wrong, I emailed my doctor and asked if we could start over with the pump at very basic settings. I asked if we could set a constant, 24 hour/day basal rate. I then suggested a 24 hours setting for each other major setting. He agreed. Since we made the change to my suggested settings, his blood sugar average has been 15 lower, and most of his readings have been around 150. The only time he has approached 250 has been when we have tested him while food was still digesting and he still had active insulin. He has gone low at night after exercise, so we have to figure that out. However, overall, things have been working out great. I guess my point of writing this is that, now more than ever, I think that the parent knows best. The doctor can only see what the pump gives him, and what he doesn't see is: - how much exercise the kid had that day - whether a high was due to a fat spike - whether the child was sick I used to rely on him to make all the key settings changes. But now I realize that this isn't rocket science and that the factors above that he doesn't see are very important. I'll still run most things by him, but I am going to be more bold about suggesting things. He is a great guy and, luckily, he is open to suggestions.