The Role, Potential Benefits and Cost-effectiveness of Digital Tools for Diabetes Management

Health and financial burdens associated with poorly managed diabetes are considerable both for individuals and for healthcare systems. The last decade has seen a significant increase in the use of automated insulin delivery systems, continuous glucose monitoring and insulin pumps. With this, digital healthcare tools - such as smart or connected insulin pens and wearable continuous glucose monitoring (CGM) sensors utilizing current digital smartphone and wireless technology have emerged - helping people with diabetes and their healthcare providers maximize treatment adherence and achieve optimal glycemic control. This article reviews the available literature to assess current unmet needs within diabetes care management, summarizes the efficacy and safety of the latest US Food and Drug Administration (FDA)-approved insulin delivery systems and digital diabetes healthcare tools, and investigate the economic and healthcare benefits of such FDA-approved digital healthcare tools for people with diabetes in the US.

Literature searches were conducted using PubMed for articles published between 2014 and 2023. Type of articles included were narrative reviews, systematic reviews, randomized controlled trials and cost-effectiveness analyses.

There are many insulin delivery systems and associated digital devices, CGMs and software applications that utilize wireless and smartphone technology available within the US that have published efficacy, safety and cost-benefit outcomes. The safety and efficacy of CGM and continuous subcutaneous insulin infusion (CSII) therapy are well established. In contrast, the evidence available for the most recent digital diabetes healthcare tools (e.g., smart or connected insulin pens) is relatively limited.

Despite the acknowledged cost-effectiveness of digital healthcare tools within diabetes care and potential associated cost savings for healthcare markets, there are limited numbers of clinical studies investigating the efficacy and safety of newer devices such as smart or connected insulin pens. Further research is needed to pave the way for integrating these devices more fully into diabetes management.