POSB30 Systematic Literature Review of Clinical, Economic, and Patient-Reported Benefits of Connected Insulin Pen Systems

Abstract

Connected insulin pen systems may improve outcomes in insulin-treated people with diabetes (PwD), potentially reducing disease burden and improving suboptimal insulin use. Within this rapidly developing field, a systematic literature review (SLR) was conducted to summarise the current clinical, economic, and patient-reported benefits of this technology. A systematic search of Medline, Embase and Cochrane library databases (limits: randomised controlled trials [RCTs], observational studies, and economic models; publication date, 2015–2021; English-language), select conference proceedings (limits: 2018–2021), US and European clinical trial registries, and the grey literature (no limits) was performed following PRISMA guidelines. Subjects were Type 1 and 2 adult PwD. Technologies assessed included: connected insulin pens/systems, insulin smart caps/sleeves, and associated mobile applications. 1,898 publications/abstracts were identified. Following screening, 11 unique studies were retained for analysis: 6 observational studies, three RCTs and two economic studies. The small size and observational design of many studies, as well as heterogeneity of outcomes, precludes drawing firm overall conclusions. However, the emerging data show a positive trend for the impact of connected insulin pens on PwD. Specifically, use of connected technologies resulted in fewer missed bolus doses, better time in range and blood glucose levels, lower incidence of hypoglycaemia, higher patient satisfaction, and lower costs. This SLR documented that connected insulin pen systems may help to reduce suboptimal insulin dosing. Studies demonstrate that these systems may help type 1 and type 2 PwDs to relieve the burden of insulin-treatment and to reduce the number of missed bolus injections, which leads to better glycaemic control. Although evidence in this field is still in its early stages, early indications suggest that connected insulin pen systems could be increasingly considered as part of routine clinical care for insulin-treated PwD who are faced with the complexity of their daily insulin routine.