The American Diabetes Association (ADA) has published a scientific statement aimed at increasing the use of diabetes technology in primary care, identifying practical barriers and offering recommendations to help bring tools such as continuous glucose monitoring (CGM), connected insulin pens and automated insulin delivery (AID) systems into everyday practice.
Why primary care matters
The statement, released online on 28 September 2026 and published in both Diabetes, Obesity, and Cardiometabolic Care and the Journal of Diabetes Science and Technology, stresses that most diabetes treatment is delivered in primary care settings but that technologies are inconsistently integrated. The ADA’s chief quality officer, Osagie Ebekozien, MD, and colleagues list workforce shortages, inadequate training, limited time, patchy data infrastructure and insurance obstacles as key reasons why adoption remains unequal.
“Most diabetes care is delivered in primary care, yet diabetes technologies remain inconsistently integrated. Workforce, training, time, data infrastructure, and insurance barriers contribute to inequitable access and adoption,”
The paper builds on previous ADA guidance that people with diabetes should have access to evidence-based technologies without undue restrictions. It is described by Eugene Wright, MD, lead author and consulting associate in Duke University Medical Center’s Department of Medicine, as a practical “road map” to help primary care clinicians use these tools more routinely.
What the statement covers
Authors emphasise that insulin delivery and glucose-monitoring technologies have evolved and can now improve both clinical outcomes and the experience of people with diabetes and their clinicians. The statement highlights specific technologies and potential advantages:
- Continuous glucose monitoring (CGM) — real‑time glucose data to support decision-making.
- Connected insulin pens — dose reminders, dose calculations and automatic dose logging to reduce missed or extra doses.
- Automated insulin delivery (AID) systems — described as fundamentally different from earlier pumps, offering simpler user experience alongside advanced glucose control.
- Mobile applications and remote coaching platforms — potential to support self-management and remote clinician oversight.
The statement notes that newer insulin-delivery devices are becoming both less complex to use and more effective, and that connected technologies can reduce treatment errors and support better glycaemic outcomes.
Practical barriers and implications
While the statement focuses on technology benefits, it maps the non‑technological hurdles that primary care teams face when adopting these tools. Key obstacles listed include:
- Workforce and training gaps that leave clinicians uncertain about device selection and interpretation of data.
- Time pressures in primary care consultations, which limit opportunities to set up and educate patients on devices.
- Inadequate data infrastructure to integrate device data into electronic health records and care workflows.
- Insurance and reimbursement rules that restrict patient access and make device adoption uneven.
By documenting these constraints, the ADA is signalling that simply recommending devices is insufficient; health systems must also address workflow, funding and technical integration to make technology useful at scale.
What this means for patients and clinicians
For people with diabetes, broader adoption of CGM, connected pens and AID could mean fewer missed doses, more actionable glucose information and potentially better day‑to‑day glucose control. For primary care teams, the statement offers a template for when and how to consider technology, and for what system‑level supports are needed.
| Technology | Potential benefit |
|---|---|
| Continuous glucose monitoring (CGM) | Real‑time glucose trends; informed treatment adjustments |
| Connected insulin pens | Dose reminders, calculations, automatic logging |
| Automated insulin delivery (AID) | Simplified insulin delivery with closed‑loop control |
The ADA’s statement stops short of mandating specific devices but reiterates that access should be evidence based and equitable. The authors frame the document as a starting point for primary care clinicians and health systems to plan training, funding and data pathways that would allow the technologies to deliver on their promise.
As clinical devices increasingly sit at the intersection of software, hardware and health services, the ADA’s guidance underlines a familiar challenge: technology alone does not improve outcomes unless the people and systems using it are equipped to do so.
