The need for delivery of small doses of insulin, together with unpredictable feeding patterns and frequent changes in nutrient intake, makes the management of neonatal diabetes challenging. The availability of continuous glucose monitoring systems in combination with continuous subcutaneous insulin infusion pumps provides an opportunity to monitor glucose levels more closely and deliver insulin more safely. We report on a preterm infant with neonatal diabetes who had profound hypoglycaemia in response to bolus subcutaneous insulin therapy, but in whom we used the combination of continuous glucose monitoring and insulin pump therapy to manage glucose control in the neonatal period, and who was discharged home on pump therapy.