How do i know when to change my daughters insulin pump settings ?

Check with her doc: This is a decision you need to make based on conversations with her diabetes doctor. It will be based on how well she is managing her blood sugar with the current settings and what changes need to be made to improve her control.

Out of control: If her blood sugars ever go lower than sixty or higher than one fifty, the setting should be changed. I recommend checking with her endocrinologist or diabetes doctor before you do that, though.