Abstract
In October 2024, New Zealand's pharmaceutical funding agency (PHARMAC) introduced fully funded access to Tandem t:slim X2 and Ypsomed YpsoPump insulin pumps, alongside Abbott and Dexcom continuous glucose monitoring (CGM). As Medtronic CGM remained unfunded, continued use of Medtronic automated insulin delivery (AID) systems incurred substantial personal cost, prompting prioritized transition to funded alternatives for all pediatric Medtronic users at our center. This retrospective audit evaluated glycemic outcomes 6 months post-transition. Ninety-eight children/adolescents transitioned AID systems; complete 6-month outcome data were available for 79 (mean age 11.6 ± 3.0 years; diabetes duration 4.68 years; pump use duration 2.44 years). Most transitioned to Tandem Control-IQ (n = 66) or YpsoPump with CamAPS FX (n = 11). Mean HbA1c decreased by 0.24% (from 7.14 ± 0.79% to 6.87 ± 0.86%; P = 0.0012), with no episodes of diabetic ketoacidosis or level 3 hypoglycemia. Funding-driven AID transitions can be safely implemented with structured education and follow-up.