Smart Pens: Expectations Regarding Use and Functionality From Health Care Providers

OBJECTIVE: As part of the 2025 diabetes and technology (dt)-report, this study explored indications for use, barriers to adoption, and perceived functionality of smart pens. METHODS: An online survey conducted between November and December 2024 gathered responses from diabetes specialists and diabetes educators (health care professionals [HCPs]) in Germany (DE), Austria (AT), Switzerland (CH), and Spain (ES). Participants estimated the proportion of individuals with diabetes who would benefit from smart pens, rated the significance of specific functions, and evaluated barriers on 5-point scales. RESULTS: The survey included 1294 HCPs (69.2% DE, 9.7% AT, 7.0% CH; 14.1% ES). Current usage of smart pens is estimated at 4% to 15% for people with type 1 diabetes and 3% to 6% for those with type 2 diabetes. However, the indication rate is markedly higher, ranging from 51% to 73% for people with type 1 and up to 69% for those with type 2 with intensive insulin therapy. Most valued features included reminders for missed insulin doses (4.4 ± 0.7), bolus dose suggestions (4.1 ± 0.8), integration with continuous glucose monitoring (CGM) apps (4.1 ± 0.8), and temperature alerts (3.7 ± 1.0). Basal insulin suggestions were considered less important (3.3 ± 1.1). No significant differences were found between physicians and diabetes educators. Major barriers included preference for disposable pens (57%), limited device options (54%), and high cost (53%). Among DE respondents, concerns over cost reimbursement rose compared to the 2024 dt-report. CONCLUSION: Smart pens are underutilized compared to expectations. Cost and reimbursement remain the predominant barriers, while reminder functionality stands out as the most valued feature.