Proper diabetes management takes diligence.
If you ignore your numbers, mistime your meals, and don’t adjust insulin to stay ahead of the highs and lows, your disease may worsen. And for many Black adults, who are diagnosed with type 2 diabetes at nearly twice the rate of white adults in the U.S., the factors compound.
This is where technology can help. If you’re stressed over your higher risk for severe complications and mortality, don’t worry needlessly. Powerful new tools are providing management and control that the tech of yesteryear could only dream of.
In a modern world filled with busy jobs, caregiving responsibilities, and countless momentary distractions, diabetes technology is changing the game.
If you’re looking to lighten the load, continuous glucose monitors (CGMs), insulin pumps, smart pens, and automated insulin delivery (AID) systems are all options.
Don’t be overwhelmed.
We’ll discuss it all in normal language so you can make the diabetes management decisions right for you.
Think of a CGM as a small sensor that’s worn on the skin – barely penetrating it – and measures glucose levels continuously, sending its readings to a phone or receiver. With CGMs, you can skip multiple fingersticks a day while still seeing trends, arrows showing direction, and alerts when numbers fluctuate.
CGMs aren’t right for everyone, but those who find them most useful often experience frequent lows, high A1C, and difficulty sensing when blood sugar is dropping. This may be the case for parents of children with diabetes, as the ability to check numbers remotely can certainly reduce nighttime anxiety.
Black patients, due to higher rates of diabetes complications, may find this increased data particularly telling. However, serious disparities remain in the literature. Black patients have historically been prescribed CGMs less often, so if your doctor has not brought it up, it is reasonable to ask.
“Would a CGM help me manage my diabetes more effectively?”
Start the conversation and explore options that your healthcare team deems best for your case.
Insulin pumps are useful. They deliver a steady stream of rapid-acting insulin that is dispensed through a small tube or patch. For people looking to replace multiple daily injections, pumps are certainly an option.
That said, users must still bolus for meals. However, because the device is more streamlined, basal rates are usually fine-tuned more precisely than with long-acting insulin pens or vials.
Do you need flexible dosing? Do you have unpredictable schedules or struggle with injections? These are all reasons to consider pumps, and as with CGMs, there are historical disparities in their use. If you are interested, ask your team about training requirements, insurance options, and whether a pump fits your lifestyle.
These ‘pens’ are essentially reusable injectors.
What makes them ‘smart’ is the fact that they can connect via Bluetooth to a smartphone app to automatically track and log insulin doses. Meanwhile, connected blood glucose meters do the same for fingerstick readings.
Typically less expensive and less visible than pumps or CGMs, these pens are a practical entry point for many people. They help reduce missed doses and provide clearer information between doctor visits, and they’re also a top choice for people who don’t want to wear a device all the time.
Consider these a strong middle ground among diabetes technologies and tools.
Also called hybrid closed-loop systems, AID systems combine a CGM and an insulin pump with an algorithm that automatically adjusts basal insulin. Some systems even help with correction doses.
If you’re seeking the least amount of manual work and better control, particularly between meals and overnight, this option may be right for you. Unfortunately, like with other diabetes tools, research shows Black youth and adults are less likely to use these AID systems, even though they’re likely to see meaningful improvements in A1C by doing so.
That said, these systems are not fully automated. They still require users to input meal data, pay attention to alerts, and maintain the device.
Here’s the good news: you don’t have to be a techie to use these tools.
You should, of course, have a basic understanding of modern devices. Again, many of these tools connect to smartphone apps that show trends, generate reports, and let you share with family or the care team.
Some of the apps are quite detailed, providing educational content, medication reminders, and food logging. You don’t have to use every feature, but with regular use, these tools can turn scattered numbers into usable patterns.
But it’s also important to remember privacy. If you’re worried about your data landing in the wrong hands, you can choose systems that let you control what is shared and with whom. For multi-generational households, especially, an adult child can view a parent’s data with permission.
Giving access to multiple family members or confidantes can help, particularly when the individual is unsure or uncomfortable with the technology.
When it comes to who benefits, the answer is quite broad.
Almost anyone using insulin or struggling with glucose variability can potentially benefit. More specifically, individuals with higher A1C, frequent hypoglycemia, shift work, or caregiving demands may see the biggest quality-of-life gains.
Again, however, because prescribing patterns have not been equal, Black patients may need to advocate more directly. In fact, one study found that Black youth with income under $40,000 are at the highest exclusion risk from essential technologies.
This means you need to ask the right questions, clearly and confidently, at your next doctor visit. If you’re hesitant about the process, definitely consider bringing a friend or family member to advocate on your behalf.
Look into asking the following:
“Given my numbers and schedule, would a CGM or pump be appropriate for me?”
“What does insurance typically cover, and am I eligible for financial assistance?”
“Are there educators who can help me understand and use these devices?”
Various community health centers, hospital diabetes programs, and some pharmacies can help train you on the technology. And, of course, peer support is available. Simply talking with other Black adults who use these devices can reduce hesitation.
That’s what this is all about.
While diabetes technologies do not replace healthy eating, movement, or medication, they are another tool in the toolkit. By learning how to use that tool, you can improve your disease management over time.
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