How do environmental concerns affect diabetes self-management choices? A recent European study asked people with diabetes what is important to them
Diabetes devices can offer fantastic benefits for glucose management and quality of life. However, anyone living with diabetes will know the environmental waste that comes with these devices. This can include glucose monitor strips, lancing devices, insulin needles and vials, infusion sets, batteries, and continuous glucose monitor (CGM) transmitters, receivers, and sensors. And on top of that, there’s all the packaging! The amount of waste for someone with diabetes taking insulin is around 1.2-1.4kg per person, per month.
Past research has shown that people with diabetes are concerned about the environmental impact of their condition. Our own work found that people with type 1 diabetes want to see more research into better diabetes technology, including making technology more environmentally friendly. But do these concerns affect the decisions people make to manage their diabetes?
How do environmental concerns impact decision making?
A new study asked diabetes communities in Germany, Austria, and Switzerland about their priorities. Researchers surveyed just under 2,000 people living with diabetes (type 1 and type 2), as well as parents of children living with diabetes. The survey asked about three environmental aspects of diabetes:
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- The reusability of medical devices
- Waste from packaging
- The role of environmental concerns when choosing technology
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Most people who responded to the survey (75%) were living with type 1 diabetes, and just under half (49%) were female. The survey found that about 2 in 3 people wanted to see more reusable diabetes devices become available. About half felt concerned about packaging waste.
Environmental impact was seen as important, but not the top priority when choosing diabetes devices (see table below).
Table: Priorities when choosing diabetes technology
| Most important | Less important | |
| Automated insulin delivery (AID system) | Pump size Tubing/tubeless Ease of use | Amount of waste |
| Continuous glucose monitoring (CGM) system | Sensor wear time (days) Sensor size Accuracy | Environmental impacts |
The people surveyed also offered ideas about reducing the environmental impacts of diabetes devices in future. They suggested this could look like:
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- More reusable devices
- Longer-lasting wear times
- Clearer communication about environmental impacts
- Carbon offsetting programs
- Recycling or take-back programs
- Using biodegradable and renewable materials in manufacturing of devices.
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What does this mean?
As a researcher and person living with type 1 diabetes, this study leaves me wondering. Ease of use and accuracy are, of course, really important. But what stops people from also prioritising their environmental concerns when choosing diabetes technology? Perhaps there just isn’t enough information available for people to compare devices by their environmental impact.
Also, I’m surprised that sensor wear time wasn’t seen as an environmental factor. Longer wear times means fewer devices required, and therefore less waste. Waste may also be minimised through things like tubeless systems and smaller devices. Perhaps reducing waste and improving device design and performance is possible at the same time.
A greener future
The environmental impact of diabetes is seen as an important issue by people living with the condition. The researchers of the study argue that manufacturers and policymakers need to invest in this area for meaningful change to be made. People with diabetes do care about the environment, but can’t make environmentally friendly choices if these don’t exist or aren’t visible.
I also acknowledge that access to diabetes treatment and technology is not the same everywhere in the world. In many places, people don’t have reliable or affordable access to insulin or diabetes devices. This means that the choices people can make are often shaped first and foremost by what is actually available to them.
Reference:
Hossman S, Lizoain A, Roos T, Brandt D, Ehrmann D, Kulzer B, Hermanns N, Trümpy C, Resl M, Diem P, Ampudia-Blasco J, Mader J, Heinemann L. Green Diabetes: Already a decisive factor for or against technology for people living with diabetes? Journal of Diabetes Science and Technology, 2026; Apr 10:19322968261436839. doi: 10.1177/19322968261436839. Online ahead of print.
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