Consensus Guideline DTECH: Technology for Glycemic Control in Type 1 Diabetes

Background: Type 1 diabetes (T1D) requires intensive insulin therapy and continuous glucose monitoring (CGM) to achieve optimal glycemic control. Advances in diabetes technology, including CGM, insulin pumps, and hybrid closed-loop (HCL) systems, have significantly improved clinical outcomes. However, their adoption in India remains variable due to cost, infrastructure, and access limitations. Objective: To develop a consensus guideline on the use of diabetes technology for glycemic management in T1D, with a contextual relevance to the Indian healthcare setting. Materials and Methods: This guideline was developed through a structured, expert-driven process involving a panel of 25 specialists across India. A focused literature review (2010–2025) was conducted using PubMed/MEDLINE and Embase. Evidence was appraised and graded using a modified Grading of Recommendations Assessment, Development and Evaluation approach, and recommendations were formulated through iterative expert consensus. Results: CGM improves glycemic control, reduces hypoglycemia, and enhances patient engagement. Insulin pump therapy offers greater dosing precision and flexibility, whereas HCL systems further optimize time in range and reduce glycemic variability. Mobile health and telemedicine provide additional benefits through remote monitoring and improved access to care. A stepwise approach to technology adoption—from optimized standard care to advanced automated systems—is recommended. Key barriers in India include affordability, limited trained personnel, and infrastructure constraints. Conclusion: Diabetes technology represents a paradigm shift in the management of T1D, with the potential to consistently improve glycemic outcomes, reduce complications, and enhance quality of life across diverse patient populations. In the Indian context, the imperative now extends beyond adoption to equitable integration, ensuring that these technologies are accessible, affordable, and sustainably implemented across all levels of care. Achieving this will require coordinated efforts in structured education, capacity building, policy support, and innovative care models. Ultimately, diabetes technology must be regarded not as an optional adjunct, but as a standard of care, with the goal of delivering better outcomes for every individual living with T1D.