It is estimated that 375,000 Americans are utilizing insulin pump therapy to manage their diabetes. This article will educate community health care nurses regarding use of the insulin pump, and how to operate special settings for more effective glycemic control. Complications of pump therapy, as well as hyperglycemia, are not always avoidable; however, interventions are in place to prevent and treat complications. Furthermore, important assessment questions are employed to assist community health nurses in evaluating the patient knowledge base and management skills of their disease process in hyperglycemic episodes and emergency situations.