Primary care providers are now asked to render care to diabetic patients that once was the province of specialists. An increasing number of these patients are using insulin pumps to manage their diabetes. Inherent in the use of pumps are unique day-to-day situations that must be addressed with timely solutions to avoid adverse metabolic effects and to maximize the benefits of this type of therapy. To increase the primary care provider's comfort level with handling these situations, this article examines four problem areas, using a case study format followed by a discussion of the solutions to each problem. The four areas reviewed are pump training and education, infusion set change issues, skin issues, and rate adjustment.