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Background: The purpose of this study is to assess if a relationship exists between A1c within target (≤ 7.5%) and frequency of patient-initiated contact with diabetes team, in children with type 1 diabetes (T1DM) on an insulin pump. Additionally, to determine factors impacting frequency of contact. Methods: This was a retrospective study of children with T1DM on an insulin pump. Frequency of contact, type of contact, and A1c were collected. Study participants filled out a questionnaire at study entry. Results: One hundred and seventy-six participants were enrolled, with a mean age of 13 years. The median duration of T1DM was 6 years with a median duration of pump use, 3.6 years. One hundred and sixteen subjects (66%) contacted the diabetes team for insulin dose adjustments between clinic visits with a mean (standard deviation [SD]) of 1.2 (± 1.7) contacts, 90% of which were by e-mail. There was no significant relationship between achieving target A1c and frequency of contact. However, increasing age and longer duration of pump use were associated with decreased frequency of contact. Common barriers to contact included being too busy and technical problems with software. Conclusions: There was no significant relationship between the frequency of patient-initiated contact with diabetes team and A1c. Overall, there was low frequency of contact in the cohort. Older children and children with longer duration of pump use had fewer contacts with low rates of self-directed pump adjustments. These results raise the importance of defining strategies to increase patient engagement and empower diabetes data review.