Innovation without inclusion? a scoping review on inequities in diabetes technology access

This study aimed to systematically map existing evidence on how emerging medical and digital technologies influence equity in diabetes prevention, diagnosis, and management. It addressed the question: How do socioeconomic, geographic, racial/ethnic, and age-related factors shape access to diabetes technologies across different populations?

Following the PRISMA-ScR guidelines, a comprehensive search was conducted across PubMed, Scopus, and Web of Science for studies published between 2003 and 2025. Eligible studies examined the impact of digital health, wearable, or pharmaceutical technologies on equity in diabetes care. Data were extracted and synthesized thematically across four dimensions of disparities: socioeconomic status, geography, race/ethnicity, and age/life stage.

From 1,635 identified records, 64 studies met the inclusion criteria. Most were from high-income countries, predominantly the United States. The findings revealed consistent disparities in access to continuous glucose monitors, insulin pumps, telemedicine, and mobile health applications. Barriers included high costs, limited insurance coverage, low digital literacy, geographic inaccessibility, and provider bias. Disadvantaged, minority, rural, and older populations were most affected.

Technological innovations have advanced diabetes care, but not equitably. Without equity-focused policy and system-level interventions, digital and medical technologies risk reinforcing existing disparities. Inclusive innovation strategies are essential to ensure fair access for all populations.

The online version contains supplementary material available at 10.1007/s40200-026-01901-y.