Insulin pumps

An insulin pump is a small battery-operated device, used by people mainly with type 1 diabetes. It's a similar size to a small mobile phone and can be clipped to your belt or waistband, carried in your pocket or in a pouch.

Insulin pumps consist of the pump itself, a disposable reservoir to store the insulin, and a disposable infusion set. The infusion set includes the tubing that connects the pump to a fine needle (or cannula) which sits just under your skin. Read more about how an insulin pump works. 

An insulin pump continuously releases small amounts of rapid acting insulin to keep your  blood glucose levels steady between meals and during sleep. You can also use it to release insulin to your body when needed, such as during a meal or snack, to help manage your glucose levels.

• Using an insulin pump can improve blood glucose control and reduce the number of severe hypoglycaemic events for people with type 1 diabetes compared to multiple daily injections.
• It's important to remember that you must continue to check glucose levels using a continuous glucose monitor (CGM) or glucose meter.

There are 2 insulin pumps which are funded – mylife YpsoPump and Tandem t:slim pump. Read more below about which pumps are funded in Aotearoa New Zealand(external link).

Insulin pumps consist of the pump itself, a disposable reservoir to store the insulin, and a disposable infusion set. The infusion set includes the tubing that connects the pump to a fine needle (or cannula) which sits just under your skin.

Insulin pumps may also be used together with a CGM plus an algorithm, that links the 2 devices together, enabling them to “talk” to each other. In this way, the pump can receive blood glucose readings from a CGM and calculate how much insulin to deliver based on your current and predicted glucose values. This is called an automated insulin delivery (AID) system. Read more about automated insulin delivery (AID) system.

How is the insulin pump connected to my body?

The pump is connected to your body through an infusion set, so the insulin can be delivered.

• The infusion set is a thin plastic tube that’s connected to a fine needle (or cannula) which sits just under your skin.
• The cannula is inserted where you would give insulin injections.
• The needle needs to be changed every 3 days.
• You can remove the tubing when you have a bath, go swimming, or when you play sports.
• The plastic tube and needles are also called 'insulin pump consumables'.

How is insulin delivered through the pump?

The insulin pump holds insulin. An insulin pump is designed to copy how your pancreas would naturally release insulin.

• The pump is programmed to give insulin at a continuous low rate during the day and night. This is called background insulin or basal insulin.

• You can also use the pump to give additional insulin at mealtimes, by entering the number of grams of carbohydrate you've eaten into the pump. The pump then delivers extra insulin for meals – this is called bolus insulin. The insulin pump will also deliver extra insulin if glucose levels are too high. These are known as corrections.

An automated insulin delivery system is made up of an insulin pump plus a continuous glucose monitor (CGM) plus an algorithm that links the 2 devices together, enabling them to “talk” to each other.

• An AID is similar to a standard insulin pump with one major difference – they have algorithms that can receive blood glucose readings from a CGM and calculate how much basal insulin to deliver based on your current and predicted glucose values.
• When a bolus dose is needed for a meal and/or correction, these systems also have calculators that can suggest a bolus amount.
• Bolus delivery is not automatic, manual programming and delivery is needed just like a standard insulin pump.

The automatic adjustments help to keep your glucose in the target range. You would still need to prompt the pump to deliver bolus doses for meals and adjust for exercise.

In Aotearoa New Zealand you are eligible to get a funded insulin pump if you have:

• type 1 diabetes
• permanent neonatal diabetes (diabetes since you were born)
• some types of “monogenic diabetes” with insulin deficiency
• type 3c diabetes, which includes includes insulin deficiency caused by pancreatectomy, insulin cystic fibrosis or pancreatitis
• some atypical inherited forms of diabetes.

AND your diabetes specialist team agree:

• an insulin pump is right for you, and
• you will benefit from an automated insulin delivery (AID) system.

Learn more about who can get an insulin pump.(external link)

There are 2 insulin pumps which are funded – mylife YpsoPump and Tandem t:slim pump. Both pumps are compatible with at least 2 types of continuous glucose monitor (CGM). If you qualify for a funded insulin pump, you can also get funded CGMs. Read more about CGMs.  

Note: The Tandem t:slim X2 will also work with the FreeStyle Libre 3 by July 2025.

Each pump's algorithm works differently, so your diabetes specialist team will discuss with you, which is the best option for you or your child. For the differences between the pumps, see the insulin pumps comparison table(external link) developed by Diabetes New Zealand.

mylife YpsoPump

• The mylife YpsoPump works with either the Freestyle Libre 3 plus CGM or Dexcom G6 CGM.
• It uses the mylife CamAPS FX automated insulin delivery system software (algorithm), to calculate the dose of insulin to administer directly into your body.
• Read more about the mylife YpsoPump(external link).

Tandem t:slim pump

• The Tandem t: slim pump works with either the Dexcom G6 or Dexcom 7 CGMs.
• It uses the Basal-IQ or Control-IQ automated insulin delivery system (algorithm) software to calculate the dose of insulin to administer directly into your body.
• Read more about the Tandem t:slim pump(external link).

Medtronic MiniMed 770G insulin pump will be discontinued

From 1 January 2025 the Medtronic MiniMed 770G insulin pump will no longer be funded for people new to insulin pumps. From 1 October 2026 the consumables for the MiniMed 770G insulin pump will no longer be funded. Read more about Medtronic (MiniMed 770G) insulin pumps – what's changing(external link).  

Your diabetes specialist team will offer you the training and support you need to get the most from an insulin pump and CGM.

The suppliers of the insulin pumps are offering phone support from 1^st October 2024.

• Tandem t:slim x2 (supplier: NZMS): 0508 634 103
• mylife YpsoPump (supplier: Pharmaco): 0800 458 267

Problems with the insulin pumps and CGMs

• Faulty insulin pumps: If the insulin pump is faulty, or an issue develops, you will need to contact the supplier.
• Faulty CGMs: If you're having trouble with your CGM or think it may be faulty, contact the supplier or your pharmacy for help. If it's faulty, the suppliers will provide you a replacement free of charge. Any CGMs provided to replace faulty ones would not count towards your annual limit.
• Broken or lost insulin pumps: If your insulin pump is broken or lost, talk to the supplier about your options. But be aware that you may need to pay for a replacement. Pharmac funds 1 new insulin pump every 4 years which is the warranty period on insulin pumps. You may be able to claim a broken or lost insulin pump on your household insurance.
• Broken or lost CGMs: There's a limit on the total number of CGMs you can have each year that takes this into account. If you’ve used more than the limit, you may need to pay for more CGMs. Check how many CGMs you can get.

Always be prepared

• Ask your healthcare provider about an action plan so you know what to do if your insulin pump stops working. If this happens, contact the helpline of the insulin pump supplier for a replacement and let your diabetes nurse specialist know. You should get a back-up pump within 24h. In the meantime, give yourself insulin using an insulin pen within 4 hours of the pump stopping guided by your pump records.

• Ensure you have enough insulin for emergencies.  As part of your emergency planning, you should have any medication or equipment supply for at least three days. The Tandem t:slim X2 insulin pump has a rechargeable battery, which needs power to re-charge. The mylife YpsoPump uses AAA batteries. It's a good idea to keep spare batteries and some charging packs for your phone and your pump in your grab bag.