The landscape of insulin delivery options for individuals managing type 1 diabetes has seen significant advancements in recent times. Despite the benefits of semi-automatic pumps in reducing complications and streamlining patients’ daily routines, their accessibility poses a challenge in Quebec as most adults are not covered by insurance for these devices.
Quebec stands as the lone Canadian province where insulin pumps are not reimbursed for adults with type 1 diabetes. While the Quebec Insulin Pump Access Program has provided reimbursement eligibility for pump purchases and supplies since 2011, only minors qualify for this program. Once minors reach the age of 18, they can no longer avail of this reimbursement, leaving adults diagnosed with diabetes ineligible for financial assistance.
Dr. Rémi Rabasa-Lhoret, a respected physician and researcher in the field, highlights the evolving landscape of diabetes management over the past three decades, with an increasing number of individuals acquiring the condition later in life.
The cost of insulin pumps is substantial. In Quebec, those eligible for reimbursement can receive up to $6,300 per pump and an additional $4,000 for supplies like catheters.
Innovations in Insulin Delivery
According to Dr. Rabasa-Lhoret, there are currently four insulin pumps available in the market. Health Canada recently approved the mylife Loop automated insulin delivery system, which integrates with the iPhone’s iOS operating system, along with the Abbott FreeStyle Libre 3 Plus sensor.
The launch of mylife Loop’s compatibility with Android smartphones in March 2025 has expanded patient choices to include two phone models. This marks the first automated insulin delivery system in Canada that can work with two glucose monitoring systems for individuals managing type 1 diabetes.
Dr. Rabasa-Lhoret underscores the significance of offering patients more options, emphasizing the positive impact on their treatment outcomes.
Enhanced Coverage in Other Provinces
Comparatively, in Ontario, more individuals with diabetes are utilizing semi-automatic pumps due to provincial coverage. Data from the BETTER registry indicates a notable increase in pump usage, rising from 30% in 2019 to over 50% presently. A similar trend is observed for small sensors, with usage increasing from just above 50% to nearly 95%.
Despite the proven benefits of semi-automatic pumps, convincing Quebec policymakers to invest in broader coverage remains challenging, as the returns may not be immediate but would be felt over the long term.
Advantages and Considerations
Insulin pumps deliver doses automatically under the skin, eliminating the need for syringes. While these pumps offer clear medical advantages by reducing hyperglycemia and hypoglycemia episodes, some patients may face challenges related to the visibility of the device on their skin, especially in personal interactions.
Although semi-automatic pumps significantly diminish the risk of severe complications, they do not eliminate the mental burden associated with managing type 1 diabetes. Individuals with this condition can make up to 300 health-related decisions daily, underscoring the ongoing challenges they face.
In Canada, the prevalence of type 1 diabetes is on the rise, with an estimated 300,000 individuals currently affected. This number is projected to reach 455,000 by 2040, reflecting a 34% increase in new cases annually between 2000 and 2022.
