Continuous subcutaneous insulin infusion therapy for treating type 1 diabetes

Published on 23 Mar 2020
Last Updated on 04 Feb 2025

Guidance Recommendations

The Ministry of Health Medical Technology Advisory Committee has recommended:

• Continuous subcutaneous insulin infusion therapy (CSII) and its consumables as a treatment option for adults and children with type 1 diabetes mellitus:

  • who use multiple daily injections of insulin (MDI) to achieve target HbA1c but result in the person experiencing disabling hypoglycaemia, where disabling hypoglycaemia is defined as the repeated and unpredictable occurrence of hypoglycaemia that results in persistent anxiety about recurrence and is associated with a significant adverse effect on quality of life (QoL); or

  • who have unacceptably high HbA1c (i.e. at 8.5% or above) on MDI despite a high level of care, where a high level of care refers to patient adherence to structured education programmes provided by a multidisciplinary team at specialist outpatient clinics in the public healthcare sector, which comprise an endocrinologist with a special interest in CSII, a diabetes nurse educator, and a dietician; or

  • where MDI is not clinically suitable and acceptable for children younger than age 12 years, and where careful consideration is made jointly by the multidisciplinary healthcare team, the children, and their caregivers who are responsible for supervising them in using CSII instead of MDI.

• CSII should be discontinued if it does not result in a sustained improvement in glycaemic control as evidenced by a fall in HbA1c levels or an increase in time-in-range blood glucose readings, or a sustained improvement in disabling hypoglycaemia, or a sustained improvement in QoL.

Subsidy status

CSII subsidies for the abovementioned indications apply only to the CSII device and its consumables listed in the Annex.

CSII Annex (as of 4 February 2025) [PDF, 201 KB]

CSII Medical Technology Guidance (4 February 2025) [PDF, 273 KB]