Tech Watch: Sensing, Pumps, Access Gaps and Paying for Outcomes

Diabetes technology continued to move towards devices that do more with less effort from the person wearing them. On 26 August 2026, the US Food and Drug Administration authorised the first sensor that measures both glucose and ketones, for people aged two and over. It is designed for people using insulin or SGLT2 inhibitors, who face a higher risk of diabetic ketoacidosis, a dangerous complication whose hospital admissions have risen 55 per cent over the past decade, according to the manufacturer. On 14 September, the agency also cleared a new tubeless patch pump with reusable and disposable parts and three day wear, compatible with sensors from more
than one manufacturer.

Yet access remains the central challenge. An international survey published in 2026, supported by industry and introduced with a foreword by IDF President Professor Peter Schwarz, gathered the views of 2,502 people living with type 2 diabetes and 888 health professionals in Germany, Italy, Japan, Poland, Saudi Arabia, Sweden, the United Kingdom and the United States. Seventy-five per cent of people with type 2 diabetes said they knew little or nothing about diabetes when they were diagnosed, and 55 per cent had little knowledge of continuous glucose monitoring. Ninety per cent of health professionals in the United States cited insurance coverage as a barrier, and 53 per cent
of those in the other seven countries cited reimbursement as a top barrier to uptake. Among people already using continuous glucose monitoring, 94 per cent said they managed their diabetes more independently.

In his foreword, Professor Schwarz wrote that “the benefits of innovation must not remain limited to those who can afford it or who live in well-resourced health systems”, and called for reimbursement and delivery models that make effective technologies available to those who can benefit from them.

Payment models are changing as well. In July, the FDA selected the first participant in TEMPO, a pilot applying a risk based approach to digital health devices offered through the Medicare ACCESS Model, a ten-year programme that links payment to outcomes for people with chronic conditions, including prediabetes and type 2 diabetes.

○ ADVOCACY ACTION FOR PARLIAMENTARIANS
Parliamentarians should ask whether national reimbursement and procurement systems are keeping pace with diabetes technology, and whether access to sensors and pumps depends on where a person lives or what they can afford. Members can press health ministries to fund diabetes education for both patients and health professionals, and to review reimbursement rules for continuous glucose monitoring in type 2 diabetes. The outcome-based payment model now being tested in the United States offers a useful example to raise with health ministers.