Smart insulin pens are an exciting recent development for people with diabetes. They can show you if you’ve missed an injection as well as how much insulin you’ve taken and the last time you injected. Moreover, they can be paired with apps that provide data from blood glucose meters as well as flash and continuous glucose monitors (CGM), so all your glucose and insulin dosing data can be stored in one place.
We’ve seen big strides in the development of insulin pump technology in recent years, and now evolving smart insulin pen technology is showing how these devices can make life a little easier for people who use multiple daily injections.
Smart insulin pens, also known as connected pens, can be used by and are beneficial to people with all forms of diabetes that inject insulin, whether you finger-prick and use blood glucose meters, or you use CGMs or flash glucose monitors.
Smart insulin pens can also connect with certain apps that let you keep your insulin dosages and blood glucose data in one place. This means you can look at the timing and dose of your insulin in relation to any food you’ve eaten or activity you’ve done to see how it has affected you. The data can also tell you how much insulin is still working in your body which can help you make decisions for unplanned activity or unexpected sugar readings.
We spoke to two members of the diabetes community to understand their experiences with smart insulin pens and explore the impact that widespread use of these pens could have on diabetes teams as well as people with diabetes.
What is a smart insulin pen?
Smart insulin pens are reusable devices that automatically record when a person has injected insulin, including how much has been injected and at what time of the day.
The devices have a dose memory display which shows the amount of time that has passed since the last dose, and they can show a person when a dose has been missed.
Once your smart insulin pen is connected to an integrated app, this information can then be sent virtually to help people manage their insulin data more easily and in one place.
Dr Tomas Griffin, a Senior Lecturer in Medicine at the University of Limerick, who spoke about smart pens and insulin pumps at the Type 1 Tech Conference 2022, says: “Smart connected insulin devices (such as smart connected pens, caps and attachments) represent the new generation of technologies designed to help people on multiple daily injections manage their diabetes.”
You can read more about injecting insulin and the different types of insulin pens available.
Which smart insulin pens are available?
There are two smart pens currently available on the NHS, both manufactured by Novo Nordisk: the NovoPen 6® and NovoPen Echo Plus®. Both are reusable and compatible with 3ml Penfill cartridges of insulins made by Novo Nordisk.
If you are prescribed a Novo smart pen and wish to use it like a standard insulin pen without the connectivity function, then you can discuss this with your clinic or healthcare provider - for example, so you can see if a different pen may suit you better.
How can smart insulin pens affect diabetes management?
Tom Dean, 33, is the founder of DiabetesChat – an online peer support community on Twitter. Tom was diagnosed with type 1 diabetes in 2006 and began using smart insulin pens in February 2022. He says it has been a ‘game-changer’ for his diabetes management.
“What I love the most about the smart insulin pens, and what I find has really changed how I manage my diabetes occurs whenever I think to myself, did I take that bolus? Did I take my background insulin?
"Before the pens, I would have struggled with this. But now I can simply check my NovoPens by pressing the memory mode down or looking back on the history log on the FreeStyle LibreLink app.
“Now I know instantly when I injected and how much. This is a total game-changer, the technology has improved my quality of life and helped lift my worries. Moreover, I can easily share all this data with my diabetes team which can be helpful in annual reviews or urgently required appointments.”
James Ridgeway, 34, is a diabetes specialist nurse (DSN) with type 1 diabetes who has seen both the personal and professional side of using smart insulin pens.
“I have been using an insulin pump for just over six months now, but before then I was using Novo smart pens. I would use the Echo Plus for my rapid-acting insulin injections, and the NovoPen 6 for my long-acting insulin.
“For me, the best thing was that it became a safety net in terms of knowing when I last injected insulin. Before insulin pump therapy I had injected over 15,000 times during 10 years with type 1 diabetes and there were times when I would ask myself 'did I give my insulin?'. NovoPens provided me with that answer, which helped to keep me safe.”
Dr Griffin adds: “Smart connected pens reduce the likelihood of errors, and this reduces an individual’s anxiety about giving insulin. This is very important.
“The people I have spoken with in clinic love having smart connected pens. They find them easy to use and tend to prefer them to their disposable pens. I have had people say to me that sometimes, they were unsure if they had taken their insulin or not. Now they just check their smartpen to see how long it has been since the last injection was delivered.”
Which apps can connect with smart insulin pens?
Providing your smartphone or tablet supports Near Field Communication (NFC) then Novo’s smart pens can be connected with the following apps:
- Mysugr
- FreeStyle LibreLink
- Glooko
- Novo’s smart pens also connect with the Dexcom G6, G7, and Dexcom One (via Glooko).
How does the connectivity between the pens and apps work?
Smart pens can be used without any smart connectivity, but the added benefits of the pens can be seen once you download the pen data onto the integrated app. For example, you can upload data from your blood glucose meter, CGM or flash glucose monitor and view your insulin dosing data alongside this, which can help you to identify patterns.
Both James and Tom have experience of connecting their smart pens with the FreeStyle LibreLink, for use with their Libre sensors.
Commenting on the interoperability between the smart pens and FreeStyle LibreLink, James says: “I have found registering NovoPen devices onto the LibreLink app very simple for myself and people in my clinic.
"The NovoPen injection data can be stored onto FreeStyle LibreView (the cloud-based data system where data can be shared with healthcare teams) which allows me to see how much insulin a person is using, and whether they missed an injection. It has simply made a positive difference to my consultations and experiences of people in my clinic.”
When asked if there was one thing he’d like to see improved, James adds: “Currently, on the FreeStyle LibreLink app a person must select if they have given an air shot or not. It would be useful and less time consuming if this could be automatically detected by the app.”
Tom began using the Libre sensor alongside smart insulin pens in February 2022. He admits that prior to FreeStyle LibreLink connectivity being made available with the pens, using Glooko to link up the smart pen alongside LibreLink for sensor readings was useful, but also a challenge. This was because he had to navigate multiple apps at the same time. But he says the FreeStyle LibreLink integration of smart insulin pens is a ‘massive improvement’.
“This change to the interoperability meant all my data was now in one place. You can see sugar levels, insulin taken and add any extra notes for food and exercise.”
How significant are smart insulin pens as a tech development?
On interoperability with connective devices, Dr Griffin says: “Traditionally a person living with diabetes could see their glucose data in one place and would have needed to keep a manual log of their insulin data – often on paper or on a different platform.
"Manually logging data is time consuming. It typically did not show the exact time that insulin was administered, for example, before or after a meal was consumed. Smart connected devices reduce this time spent logging and provide more precise data.”
Dr Griffin adds that he is also now seeing the benefits of device connectivity in clinics. “The rich data has allowed me to have more meaningful consultations that are beneficial for the person living with type 1 diabetes and their families.
“It has allowed engaging and open dialogue where we have been able to sit down and look at a someone's insulin data and glucose data on the same platform and using this data, together, we can develop some strategies that can help the person using the smart pens achieve their personalised goals.”
