Healthcare professional requirements for the care of adult diabetes patients managed with insulin pumps in Australia

Intern Med J. 2015 Jan;45(1):86-93. doi: 10.1111/imj.12619.


Background: Healthcare professional (HCP) time supporting insulin pump therapy (IPT) has not been documented, yet it is important in planning and allocating resources for effective care.

Aim: This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery.

Methods: Twenty-four Australian adult IPT-experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP-patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre-pump education until stable on IPT.

Results: Data on 2577 HCP-adult patient interactions (62% face-to-face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre-pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0-20.9), 2.4 (0.5-6.0) and 1.8 (0.5-5.4) hours per patient from nurses, dietitians and doctors respectively.

Conclusions: IPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources.

Keywords: health resource; health service need and demand; insulin; insulin infusion system; type 1 diabetes mellitus.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Australia / epidemiology
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Female
  • Health Personnel / standards*
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Insulin / administration & dosage*
  • Insulin Infusion Systems / statistics & numerical data*
  • Male
  • Middle Aged
  • Morbidity / trends
  • Practice Patterns, Physicians' / standards*
  • Professional-Patient Relations*
  • Prospective Studies
  • Young Adult


  • Hypoglycemic Agents
  • Insulin