RSSDI consensus statement on the use of diabetes technology in India

Background Diabetes technology use in India is constrained by affordability, infrastructure, training and continuity of support. This RSSDI consensus provides evidence-informed, resource-adapted recommendations for technology selection and implementation. Methods Following literature review, statements underwent two modified Delphi rounds. Consensus required ≥ 75% of respondents to rate statements 7–9 on a nine-point scale. Round 1 included 60 participants; Round 2, 33. Evidence was not formally graded. Results The consensus comprises 45 statements across eight domains: self-monitoring of blood glucose, continuous glucose monitoring, automated insulin delivery, telemedicine and digital health, wearables, resource-adapted care, special populations and overall principles and policy. Recommendations emphasize structured glucose monitoring linked to actionable treatment decisions; early access to continuous glucose monitoring and automated insulin delivery in type 1 diabetes; and individualized technology use in type 2 diabetes and special populations. Standardized interpretation of glucose data, structured education, backup monitoring and insulin-delivery plans, and continuing clinical and technical support underpin safe use. Clinician-supported remote care can extend access, while artificial intelligence tools require clinical validation and consumer devices claiming unvalidated glucose measurement should not guide treatment. Resource-adapted pathways and public and insurance support are prioritized to improve equitable access. All statements achieved consensus, with agreement ranging from 75.8% to 97.0%. Proposed community-based implementation models require prospective evaluation. Conclusions This consensus provides a practical framework for integrating diabetes technologies into Indian care, aligning selection with clinical need, preferences, affordability and service capacity, and identifying priorities for equitable access, policy and research.