Technological improvements have offered potential to improve outcomes in both Type 1 and Type 2 diabetes. Advances in glucose monitoring, accurate pumps and effective algorithms have led to a range of devices aimed to provide improved glycaemic control, reduced hypoglycaemia and improved burden of care. Despite this progress, challenges remain before technology based solutions are widely available. These include clinical trials, long term outcomes monitoring and importantly funding to allow patient access. In Australia, two decades after the advent of modern pump therapy there remains debate over reimbursement and a wide discrepancy in pump usage based on age and socio economic status. Importantly there is no clear pathway for the reimbursement of new technologies into the future. It is a key time to explore and establish an approach so that resources and effort can be used efficiently for the benefit of patients with diabetes.