Insulin Pump Therapy

What is an insulin pump?

An insulin pump is a small device that delivers a continuous supply of insulin through a thin flexible tube (cannula) inserted under the skin. The pump holds a reservoir filled with rapid acting insulin, and is programmed to give small amounts of insulin continuously. When you need extra insulin before meals or before a snack, you push the buttons on the pump or app on your phone to deliver the right amount of insulin to match the carbohydrates you eat.  The infusion set or pod that contains the cannula is changed every 2 or 3 days. Newer pump features allow for increased safety and better insulin management, as the pump can automatically make adjustments to insulin infusion rates to prevent both low and high blood sugar levels.

What to consider if you are thinking about a pump:   Advantages Can provide better blood glucose control Allows more flexibility to adapt to day to day life Convenient because it is always with you Fewer injections Fewer and less severe low blood sugars Disadvantages Something is always attached to you More rapid onset of Diabetic Ketoacidosis (DKA) if there is an interruption in the insulin delivery There is a lot of education and ongoing follow-up required to be successful with an insulin pump

Questions to ask yourself:   What do I expect from pump therapy? How will a pump fit into my daily life? How do I feel about having a pump attached to me at all times? How will a pump affect times of intimacy? Have I talked to someone who is using a pump? Am I willing to test my blood sugars a minimum of 4 times per day? Do I rotate my injection sites? Am I willing to learn and do carbohydrate counting? Am I willing to visit the Diabetes Education Centre for regular follow-up? Am I comfortable making insulin adjustments based on my blood sugar results?

ADP-Approved Insulin Pump Programs

Insulin Pump Companies

Funding Assistance for Insulin Pumps

The Assistive Devices Program (ADP) through the Ontario Ministry of Health and Long Term Care (MOHLTC) provides funding to support you with an insulin pump.  If you meet the eligibility criteria for a pump, 100% of the price of your pump is covered and paid directly to the supplier.  You will also receive a grant paid to you 4 times/year to help cover the cost of your supplies.  You must attend one of the ADP approved Diabetes Education Programs.   For a referral to a program near you, click here.  

For more information on the ADP program for insulin pumps, please click here

Frequenly Asked Questions:

What is the Assistive Devices Program (ADP)?   ADP is a government program that provides financial help to pay for an insulin pump and some supplies.

How much financial help does ADP provide?   ADP Covers:  The cost of an insulin pump and $600 for pump supplies every 3 months (includes reservoir/cartridges, infusion sets, tubing)

Do I have to keep receipts?  You must keep all your receipts for 2 years to prove the money was spent on these items.  ADP may ask you at any time to validate your expenses. 

What won't ADP cover?  ADP does NOT cover all of the costs of pump supplies – you will need to spend some of your own money on pump supplies to get all the supplies you need. You can expect to pay about $50-100/month – possibly more if you buy accessories or change your insertion site more often. ADP does not cover the cost of insulin test strips, ketone strips, insulin lancets,or needle tips

What do I need to do in order to start receiving ADP funding? In order to start on an insulin pump and get ADP funding, you must meet all of the following criteria: 

• Be referred to an ADP authorized diabetes education centre
• Have a valid OHIP card
• Have an Ontario address
• Have type 1 diabetes and be at least 19 years of age 
• Take basal and bolus insulin for at least 1 year 
• Be able to count carbohydrates and adjust insulin based on your insulin to carbohydrate ratio and correction factorCheck your blood ketones when your blood sugar is over 14 mmol/L and know what to do if you have ketones
• Know what to do if you are sick 
• Have attended at least 3 visits with your diabetes team in the past year 
• Bring your blood sugar information to each diabetes appointment

When will I find out if I have been approved for ADP funding?   The timeline for processing ADP applications is up to 8 weeks (faster if you arrange direct deposit). If the application is completed correctly, you can expect your first cheque within this timeline. You will not receive a notice that you have been approved before you receive the cheque. 

What if I change my mind or decide pump therapy is not for me?  You will have a 90 day trial period once you start using an insulin pump. During this time, you will work with your diabetes team to: 

•  Help you learn how to use the pump
• Assess and adjust your basal rates
• Assess and adjust your bolus calculator settings (carbohydrate to insulin ratio, blood glucose targets and insulin correction factor)
• Determine if the pump is working well for you

You will be asked to keep in touch with your diabetes team regularly by phone or email. This will take a lot of time. In the first 90 days, you will need to test your blood sugar, log your insulin doses and food intake more often than usual. 

How Do I Get Started?

• Tell your Diabetes Specialist/Endocrinologist that you would like to be considered for an insulin pump
• Arrange an appointment with your Diabetes Education Program to discuss pump therapy
• Discuss what you have to do to meet the ADP conditions and how long that will take
• Review the types of pumps available and decide which one is best for you
• Check to see if you have insurance coverage through your benefit plan or if under 25 years old-your parents benefit plan
• Once you meet all the ADP conditions, agree on a date to start wearing the pump and learn how to use it.

How is ADP Funding Renewed?  Funding is renewed each year. The ADP office mails a renewal form about 2 months before your renewal 

is due. The ADP form must be filled out and signed by your diabetes doctor. Book your appointment well 
in advance of your renewal date to have your ADP renewal form signed. 

What is the Criteria to Have ADP Funding Renewed? You must meet all of these criteria:

• Test your blood sugar at least 4 times/day or have continuous glucose monitor data

• Have brought your pump data management reports and food records to every visit with your diabetes team (pump data would be from one of the following: Carelink for Medtronic pumps, Glooko for Omnipod pumps, Tandem Source or Glooko for Tandem pumps)

• Show that you are carb counting and using an insulin to carb ratio 

• Show that you know how to take extra insulin for high blood sugars by using a correction factor

• Check blood ketones when your blood sugar is over 14 mmol/L and know what to do if you have ketones 

• Have attended at least 3 regular follow-up visits with your diabetes team during the previous year

• Have your diabetes doctor sign your ADP renewal form 

You will need to reapply for ADP funding once a year. You must meet all of the above criteria to qualify for renewal. If you do not meet this criteria, you may have your ADP funding denied. 

How do I Show That I am Meeting ADP Criteria?  You will need to: 

• Attend regular diabetes appointments – at least 3 each year
• Bring these to all of your diabetes appointments: 
• Pump data management reports
• Blood glucose meter or continuous glucose monitor reports 
• Food records

I Have Had a Pump for 5 Years. Am I Eligible for a New Pump?  No, not necessarily. ADP does not provide automatic replacement when the warranty has expired or after 5 years. A new pump is provided only if the pump is no longer in good working order. 

When Does My Pump Warranty Expire? Most pump companies provide at least a 4 year pump warranty that begins on your pump start date. 
Check your pump warranty with your pump company.

Can ADP Funding Be Taken Away?  Yes. If you do not meet the renewal criteria, your funding may be stopped or delayed until the criteria are met.