Thousands of New Zealanders living with type 1 diabetes face a frustrating wait for potentially life-changing technology, despite a recent announcement from Pharmac that continuous glucose monitors (CGMs) and insulin pumps are now fully funded.
Last August, the drug-buying agency announced that CGMs and insulin pumps would be made universally available for people with type 1 diabetes. However, many have told 1News that while the CGMs are easy to access, they will have to wait up to five years before they can receive an insulin pump.
Health NZ Te Whatu Ora confirmed that the delays in the rollout of insulin pumps are due to significant staff shortages, with some clinicians estimating the country has only about half the number of specialists required to meet international standards.
‘No choice but to look elsewhere’
Christchurch mother Kat Evans, who was diagnosed with type 1 diabetes in August 2023, was thrilled when she learned late last year that CGMs and insulin pumps would be funded.
However, after seeing her medical team in November, she was informed that she could face a wait of two to five years for the insulin pump.
“In that situation, we had no choice but to look elsewhere and go private,” she said. “That’s when I discovered the Aotearoa Diabetes Collective in Hamilton. I couldn’t be more grateful. In just two weeks, everything was arranged and approved.”
Evans said she’s “got my life back” after receiving the CGM and pump.
“It’s been phenomenal. I feel human again.”
‘Significant’ workforce shortage
The delays have raised concerns among healthcare professionals, including Dr Rosemary Hall, the president of the New Zealand Society for the Study of Diabetes.
While she welcomed the recent funding announcement, she acknowledged the frustration caused by the delays.
“There’s overwhelming evidence that the earlier people can access these technologies, the better the long-term outcomes and the immediate quality of life,” she said.
“It’s heartening to hear the positive changes in lifestyle and fewer hospital admissions that many people are experiencing.”
Hall said the primary cause of the delays is the ongoing shortage of specialists.
“We have significant shortages across the system. In some areas, there are only half the number of staff needed to meet international standards.”
The endocrinologist said while she was unsurprised some people were choosing to seek out private healthcare options, the fact it was necessary was “a tragedy”.
There are around 25,000 people living with type 1 diabetes in New Zealand, with nearly 2500 having already received a prescription for an insulin pump. However, the process of setting up an insulin pump can be complex, requiring one-on-one training and input from a team of medical specialists, including endocrinologists, nurse practitioners, and dietitians.
Hall said all those key roles involved in setting up an insulin pump are already “overworked and understaffed”.
Dr Ryan Paul, co-lead for the National Diabetes Network at Te Whatu Ora, said the situation is frustrating.
“It’s very post code-dependent, and it’s unfortunate that some centres are struggling to provide insulin pumps. The main issue is workforce capacity,” he said.
“No area has enough staff compared to international standards, and this is a challenge across the entire health system.”
Barriers to access
Health NZ is now working on initiatives to improve access to diabetes technology, including a project aimed at identifying local barriers to accessing technology and a national hub to streamline pump therapy access.
“We’re also focused on increasing the specialist workforce in both outpatient and community settings to ensure people with diabetes get the best care,” Paul said.
He said the diabetes specialist workforce hasn’t changed significantly over the past few years, despite predictions of an influx of both type 1 and type 2 diabetes over the next two decades.
“It’s something we’ve been advocating for and we’ll continue to fight for.”
Health Minister Simeon Brown said New Zealand is following similar trends seen overseas.
“We’ve seen similar issues in other countries where thousands of people have gained access to these technologies. There are challenges, but Health NZ is developing a national coordination plan to speed things up,” he said.
