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Expert opinion

The smart pen era is here

Dr Tom Crabtree, Diabetes and Endocrinology registrar and ABCD research fellow at the University Hospitals of Derby and Burton NHS Trust, shares his thoughts on smart insulin pens.

Dr Tom Crabtree

Over time as clinicians, we’ve got a lot better at learning about the burden of living with type 1 diabetes. Often it can feel like you’re juggling or spinning plates and my theory is always that if we can make things easier for people with type 1, then we should.

Since the COVID pandemic, we’ve been forced into a position where fewer face-to-face appointments are available. Care is now being delivered wholly, or in part, through virtual or telephone consultations which can make it difficult to have a data-driven consultation.

We need to have more options available so that we can tailor the care and technology that we’re providing.

Seeing the full picture

My view is that data is power. Without the insulin data, and even with just the glucose data, we’re only getting half the story.

We want to be able to see all of your data on one system. One potential solution is connected pens or smart pens. What these do is allow insulin dosing information to be recorded which is then stored in the pen and can be uploaded to an online system via apps like Glooko, facilitating review in the cloud.

Or, if you turn up to clinic with your pen, we can download the data and together review the insulin that you’ve been taking. It bridges a gap between injections and pump for people who are on that journey through technology.

Glooko software that allows you to upload data from your glucose monitor

Simple yet smart

So what are we looking for as your healthcare teams when we’re looking at these smart pens? We want them to be easy to set up, very user-friendly. We want you to be able to get your hands on them and use them with minimum training.

NovoPen® 6 is the one that we have available at the moment, and NovoPen Echo Plus® is the paediatric half unit. But there are other examples that are coming to market soon.

You may see Sanofi Smart Cap  in the next year. This is a cap that goes on to a regular disposable pen, which will record the dose of insulin taken and the data can be downloaded. Medtronic’s InPen™ will be compatible with multiple types of insulin and will come with an app that will be able to do some more sophisticated calculations. And you may also see the Tempo Smart Button™,  a cap that attaches to a bespoke disposable pen.

One size may not fit all

For me, connected pens are a really simple means to provide additional support to anyone using injections and to facilitate data-driven consultations and personal reflections.

We want to get these devices into the hands of people who need them, beyond social and economic deprivation barriers. But we don’t want to widen any digital divide that might exist.

So, we still need to consider the impact on those who cannot or do not want to access these sorts of technologies and how we can reach them.

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