In December 2006, the Ontario government began a program that provides funding for insulin pump therapy to children and youth aged 18 and under who met the clinical criteria. Funding was then extended for those patients in the program turning 19 (while the Insulin Pump and Supplies for Adults Expert Panel, chaired by Dr. Bruce Perkins, assessed the clinical needs of adults with type 1 diabetes) for insulin pump therapy. As of September 2008, this $62 million investment will allow funding for insulin pumps and supplies to be extended to all adults with type 1 diabetes who meet the clinical criteria for funding under the Assistive Devices Program (ADP). Today, about 1700 children and youth benefit from the Ministry-funded insulin pump therapy and in September 2008, over 1300 adults will receive funded insulin pumps every year.

• At what age does an adult qualify for the adult insulin pumps program?
• What criteria must be met for someone with diabetes to be eligible for this program?
• Where will the diabetes teams be located and how can they be accessed?
• When will ADP begin providing funding for this program?
• If an individual has already purchased an insulin pump, will they be reimbursed or funded retroactively?
• Children and youth have continued to receive funding for supplies once they have turned 19, although they are no longer eligible to receive clinical support from their paediatric diabetes program. Will these individuals be automatically registered with an adult program?
• Will the program pay 100% of the price of the insulin pump for those who are eligible?
• Does the funding cover supplies as well?
• How often will an individual be able to access funding for an insulin pump and supplies?
• Why isn't the government covering insulin pumps for type 2 diabetics?
• How many type 2 diabetics are insulin dependent? When will they be eligible for the free pump?

Children and youth are eligible for the insulin pump and supplies program until the age of 18. The adult insulin pump and supplies program is for people 19 years of age or older so that there is no break in funding.

People over 19 years of age with type 1 diabetes who have been unable to achieve good blood sugar control with multiple daily injections may benefit from the use of an insulin pump. The individual must be assessed by a diabetes team consisting of a specialist physician and diabetes educators who will examine the individual’s readiness for pump therapy and determine eligibility for ADP funding assistance.

The ADP is currently in the process of registering diabetes teams across the province to provide insulin pump therapy to adults. Once the programs are registered, ADP will provide the diabetes teams with training on the specific clinical criteria required to be eligible for funding and the process that will be in place to submit an application to ADP. The clinical criteria will be specific to meet the needs of adult individuals with type 1 diabetes.

ADP will begin providing funding in September 2008.

Funding will not be retroactive, once an individual is assessed by a diabetes team as meeting the clinical criteria, the application for funding will be submitted and processed by the ADP.

When ADP has a complete list of registered diabetes teams who will be providing insulin pump therapy for adults, the list will be provided to all paediatric diabetes programs and sent directly to individuals who have turned 19 so that they can register with the closest program.

The program covers 100% of the price of the insulin pump, paid directly to the vendor.

A yearly grant of $2,400 is provided to approved clients for associated supplies; the grant is paid out quarterly directly to the individual.

Funding for insulin pumps can be renewed every five years. Once an individual is eligible for the program, they will receive funding for supplies on an ongoing basis.

A panel of experts consisting of physicians and other health care professionals with expertise in the treatment and management of diabetes was asked to provide recommendations on providing funding assistance for insulin pumps and supplies to all insulin-dependent diabetes. The panel reported that the evidence to support the use of an insulin pump by type 2 diabetics is unclear and that there is little clinical trial evidence to support this recommendation at this time. In 18 - 24 months the panel will review the medical literature and reconsider the question of extending funding to type 2 diabetics.

Approximately 30% of type 2 diabetics are insulin dependent. The eligibility of type 2 diabetics for a free insulin pump and associated supplies will be considered by an expert panel in 18 - 24 months.

© Queen's Printer for Ontario, 2002  |  Privacy Policy  |  Disclaimers  |   Last Modified :