Study Reveals Digital Diabetes Management Tools Fall Short on Clinical Benefits and Increase Healthcare Spending

New research from the Peterson Health Technology Institute (PHTI) reveals that digital diabetes management tools are failing to deliver expected clinical benefits and are contributing to increased healthcare spending.

Type 2 diabetes, now affecting even younger Americans, has seen a significant rise in prevalence from 10.3% (2001–2004) to 13.2% (2017–2023), and is only expected to continue increasing, according to the analysis.

The American Diabetes Association (ADA) recommends collaboration between patients and primary care providers through regular in-person visits is ideal for type 2 diabetes management.

Treatment typically involves oral medications, insulin injections, and other drugs targeting cardiovascular and renal risks, alongside behavior changes such as diet and weight loss.

The ADA also recommends a diverse healthcare team, including primary care providers, diabetes educators, health coaches and community health workers, to ensure effective management.

Given the role of patient self-management in diabetes care, there has been significant investment in digital diabetes management solutions, with a focus on encouraging patients to improve glycemic control through remote monitoring, behavior/lifestyle modifications and nutritional ketosis to induce diabetes remission, the analysis said.

To assess the results of digital diabetes management, PHTI used evidence-based framework and reviewed over 1,100 articles, including 120 submissions from companies that shared evidence on the clinical and economic impact of these technologies.

The analysis analyzed eight widely used tools from companies including DarioHealth, Glooko, Omada, Perry Health, Teladoc (Livongo), Verily, Vida and Virta.

These tools revealed only minor reductions in hemoglobin A1c (HbA1c) levels, the standard form of measurement of glycemic control in diabetics, below industry standards for clinical significance.

Research indicated that these digital tools only provided slight decreases in HbA1c levels, ranging from 0.23 to 0.60 percentage points compared to regular care.

However, these improvements fall short of the industry’s standards for Minimal Clinically Important Difference (MCID) of 0.50 percentage points.

In addition, these tools did not demonstrate enhancements in other health factors such as weight loss, body mass index, blood pressure, cholesterol or other common conditions impacting people with diabetes. Nor did they address health equity concerns, particularly impacting low-income and diverse communities, research found.

The analysis by PHTI revealed that the cost of these solutions surpasses potential healthcare savings, with limited clinical efficacy, which results in annual spending increases for patients, contributing to overall healthcare costs.

Data revealed that patients using remote monitoring tools may see their spending rise by $2,002 (commercial insurance), $1,011 (Medicare), and $723 (Medicaid), while behavior modification tool users may experience increases of $484 (commercial), $513 (Medicare), and $574 (Medicaid).

Caroline Pearson, PHTI's executive director, emphasized the need for innovation considering these findings, in a news release.

“Patients with diabetes invest time, energy, and resources in these tools, and they deserve to experience meaningful, positive benefits for their health,” Pearson said. “The healthcare sector as a whole needs transparent, accurate information about the clinical and economic impact of these digital tools that are taking up precious healthcare dollars.”

While Virta showed promise in achieving meaningful glycemic control benefits for certain users, the overall impact of digital diabetes management tools remains limited.

PHTI's evaluation highlights the urgency for more effective solutions to improve diabetes care and reduce healthcare costs.