Recently, a review article by the team led by Professors Guo Lixin and Pan Qi from Beijing Hospital was published in the journal Aging Med (Milton), interpreting the Guidelines for the Diagnosis and Treatment of Diabetes in the Elderly in China (2024 Edition). The review focuses on the principles, clinical benefits, and application challenges of relevant technologies, aiming to improve the long‑term prognosis of elderly patients with diabetes. The first author of the article is Dr. Cai Qingyun from Peking Union Medical College.
The insulin pen was invented in 1985, storing insulin in a cartridge for subcutaneous injection via a pen‑like device. It quickly became an essential tool for multiple daily injection (MDI) therapy. For some patients, standardized insulin injection is critical to achieving glycemic control goals. However, insulin adherence among elderly diabetic patients is generally insufficient, and problems such as missed doses, repeated injections, and dosage errors are common in clinical practice.
The insulin pen has evolved from a simple injection tool into a more sophisticated device, equipped with a digital display and a push‑button injection mechanism, replacing the traditional manual pressure injection. Smart insulin pens feature automatic recording and intelligent connectivity, accurately tracking hundreds of insulin injection records, including the date, time, dosage, insulin type, and temperature range of the most recent injection. By converting insulin injection behavior into “digital” data, these devices reduce the burden of manual recording and improve accuracy.
In addition, smart insulin pens are equipped with visual and auditory alerts to prevent missed or repeated injections, ensuring the accuracy of timing and dosage. The devices can also connect to smart devices via near‑field communication (NFC) technology, transmitting injection records to smartphones and providing patients with “visible” feedback on their injection behavior.
Studies have shown that the use of smart insulin pens can significantly reduce missed injections, prolong time in range (TIR), and reduce exposure to hyperglycemia and hypoglycemia. Elderly patients benefit particularly markedly, suggesting unique advantages of this technology in compensating for memory decline, visual impairment, and operational difficulties. Meanwhile, smart insulin pens have demonstrated favorable cost‑effectiveness with relatively controllable pricing.
However, real‑world barriers remain to their widespread adoption, including difficulties among some elderly patients in performing tasks such as changing needles and loading cartridges, as well as unfamiliarity with smartphone applications.