I have struggled with this same issue. As a T2, have been using insulin for two years and I still struggle with certain things like Darn Phenomenon. I inject 4-6 times/day and test 6-8 times a day and am very diligent about my diet, all of which my endo is aware of.
But getting a pump from my insurance is no cake walk. The immediate answer will be no and it will require my doctor establishing the medical necessity of the pump. My insurance (Aetna) policy follows Medicare and allows you to either be grandfathered in by having a pump before joining Aetna or to satisfy a set of conditions:
1.The member has been on a program of multiple daily injections of insulin (i.e., at least 3 injections per day), with frequent self-adjustments of insulin dose for at least 6 months prior to initiation of the insulin pump*; and
2.The member has completed a comprehensive diabetes education program; and
3.The member has documented frequency of glucose self-testing an average of at least 4 times per day during the 2 months prior to initiation of the insulin pump; and
4.The member meets at least one of the following criteria while on multiple daily injections (more than 3 injections per day) of insulin:
a.Dawn phenomenon with fasting blood sugars frequently exceeding 200 mg/dL; or
b.Elevated glycosylated hemoglobin level (HbA1c greater than 7.0%, where upper range of normal is less than 6.0%; for other HbA1c assays, 1% over upper range of normal); or
c.History of recurring hypoglycemia (less than 60 mg/dL); or
d.History of severe glycemic excursions; or
e.Wide fluctuations in blood glucose before mealtime (e.g., pre-prandial blood glucose levels commonly exceed 140 mg/dL)
I can easily satisfy the first three conditions, but the fourth condition requires me to display what I consider to be poor control. I consider myself very good at using insulin to control my blood sugar. I know that if I had too, I could use syringes and vials of R/NPH and attain reasonable control. I am just a bit angry as a T2, that the patients that display poor control are granted a pump rather than patients who could benefit the most.
And this last statement, in my view is most important. A pump is no better then injections if you don't use it effectively. The data I have seen suggest that T1 patients moving to the pump reduce their A1c by 0.5% on average (whoop dee doo). There are many patients that get greatly improved control. Those are the patients that "really" use the pump. To really use the pump, you need to make dozens of more decisions each day (over injections). I'm not always clear that a patient who doesn't properly count carb, test and inject their insulin will do any better using a pump.
In the end, I suspect that my endo could make the case that a pump is warranted for me through the necessary proof of medical necessity, but for right now, I consider insulin pens easier for my active life. I travel a good deal and am outside, a pump requires more supplies and backups. I just grab a few pens, a bunch of pen needles and my frio and I am fine.