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Digital Diabetes Management Solutions

Assessment Released

Last Updated

April 19, 2024


Type 2 Diabetes

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PHTI conducted an evaluation of digital diabetes management tools that support improved glycemic control in people with type 2 diabetes.

Area overview

Type 2 diabetes impacts almost one in seven people in the United States and is the most expensive chronic condition, leading to significant clinical complications. Given the critical role of patient self-management in diabetes, there has been significant investment in creating digital diabetes management solutions with patients as the primary users.

The core objective of these solutions is to support improved glycemic control through tracking of blood glucose, paired with additional education and support. These solutions use three broad approaches:

  • Remote patient monitoring—Enable physicians to support remote patient monitoring of blood glucose levels with a goal of improved glycemic control.
  • Behavior and lifestyle modification—Engage patients with a mix of behavioral, clinical, and lifestyle modification programs in addition to glycemic feedback with a goal of glycemic control and other health improvements.
  • Nutritional ketosis—Induce a state of ketosis in patients through intensive dietary guidance and monitoring of glycemic and ketone levels with the goal of diabetes remission.

Read the Executive Summary

Download the evaluation

Digital Diabetes Management Solutions

Released March 21, 2024

March 28, 2024


March 21, 2024

Executive Summary

March 21, 2024

Providers’ Guide

March 21, 2024

Patient Guide
Report contributors and reviewers provided important expertise and insight throughout our process. Those who directly contributed to the report have no relevant conflicts of interest to disclose.


Summary of findings

Digital diabetes management solutions in the remote patient monitoring and behavior and lifestyle modification categories do not deliver meaningful clinical benefits, and they increase healthcare spending relative to usual care. The evidence showed that improvements in glycemic control for patients using digital diabetes management solutions were minimal and short-term. 

After accounting for the average price of these products, these solutions increase net healthcare spending for purchasers because the small, estimated savings are less than the cost of the solution. Exceptions may include 1) people with higher starting HbA1c who are newly starting insulin, and 2) people seeking diabetes remission through nutritional ketosis.

These findings are based on the criteria set forth in the ICER-PHTI Assessment Framework and the currently available evidence. PHTI conducted a secondary research review that relied on published literature and information. PHTI did not conduct original testing of the tools. Please see the full Digital Diabetes Management Solutions report for the complete assessment, methods, and recommendations.

Guidance & considerations for stakeholders


  • Require data analysis and transparency
  • Align payment for solutions with their clinical performance, including financial performance guarantees in contracts
  • Focus the deployment of solutions to patients with the highest HbA1c levels


  • Clinical evidence generation is critical to support adoption
  • Sustainability of clinical benefits is central to a solution’s impact
  • Provider acceptance and engagement matters
  • Contract for results


  • Performance may vary by sub-population
  • Diabetic remission is a worthy goal that may be supported with effective digital solutions
  • Be aware that many digital health solutions are cost-additive

Why assess digital diabetes management tools?

Additional resources

October 2023

Assessment Area Brief

Assessment area brief for PHTI’s assessment of non-continuous glucose monitoring solutions associated with a mobile or web application to guide therapeutic workflows.

October 2023

Diabetes Remote Patient Monitoring Methodology Overview (Presentation with Audio)

A review of PHTI protocol for systematic literature review of clinical impact.

October 2023

Systematic literature review of remote patient monitoring among patients with type II diabetes

International prospective register of system reviews (PROSPERO), National Institute for Health and Care Research


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