We need to tackle the increasing mountain of wasted plastic and cardboard from diabetes technologies

For people living with diabetes, access to an insulin pump or sensing technologies such as continuous glucose monitors is life changing. Yet there is a downside—the mounting piles of plastic, paper, and cardboard that each device comes with. This packaging is becoming a worry to users, particularly those who are environmentally conscious. With every delivery of diabetes technology supplies comes several, often oversized, cardboard boxes. Each cannula, reservoir, or sensor is wrapped in plastic to maintain sterility.

The number of people living with type 1 diabetes around the world is increasing, and is predicted to rise from 8.4 million to 17.4 million by 2040. While the number of people with diabetes increases, the number of people accessing and using diabetes technology is increasing even faster. Emerging technologies such as hybrid closed loop (HCL) systems will only increase these numbers. Alistair Lumb, speaking at the annual Diabetes Technology Network of which he is chair, said, “It took 15 years to get 45 000 people onto insulin pumps—we now have five years to get around 70 000 onto HCL.” Technology can help to alleviate some of the burden of managing the condition and reduce the risk of developing complications. It allows people to live their lives with both reduced decision making and improved clinical outcomes, including more time in range and reduced incidence of severe hypoglycaemia.

Many people with diabetes want to reduce the waste from their diabetes technology, but advice on what can be recycled is often unclear. As insulin pumps became more common, patients were advised that all waste should be disposed of in medical waste bins. Many of us, through the years, have opted for a more realistic approach and choose to recycle the cardboard, at least. Much of the plastic packaging is medical grade, however, and cannot be processed by domestic recycling services. Advice from diabetes teams, pharmacists, and GPs is mixed and leaves people using these devices confused and often feeling guilty about their environmental footprint.

Device companies need to take more responsibility. At present, guidance from the main providers about what can be recycled and how is limited and confusing. Some companies provide statements on the importance of the environment and sustainability,12 but most have yet to provide any clear action. One of the big frustrations is the huge paper instruction books provided in every box of consumables delivered. These books can be over 100 pages long and often just go straight in the bin. Many are available online, so why couldn’t they be accessed using a QR code printed on the box? Many diabetes devices already require users to have a mobile phone.

Some companies have introduced reusable applicators and we hope to see more initiatives like these. Insulet has a programme which provides users with a way to dispose of used pods to help reduce landfill and prevent excess waste.3

For many people living with type 1 diabetes the ability to reduce waste around their technology is important. As a community we need more information and guidance on how we can recycle the products we have. We also want diabetes technology companies to develop more initiatives—such as making reusable products, reducing packaging waste, and initiating return to recycle projects. It is important for medical technology companies to understand patients’ needs and motivations when it comes to recycling and diabetes tech consumables. Clear information and guidance is crucial.