Managing diabetes one step at a time in Low- and Middle-Income Countries (LMICS): the promise of wearable devices

The global burden of diabetes mellitus disproportionately affects low- and middle-income countries (LMICs), were limited healthcare infrastructure hampers timely and effective disease management. Wearable technologies, such as continuous glucose monitors (CGMs), insulin pumps, and fitness trackers, offer a transformative opportunity to bridge care gaps by enabling real-time monitoring, personalised feedback, and improved glycemic control. Evidence shows wearables enhance patient engagement, support clinical decision-making, and reduce complications. However, significant barriers such as cost, digital illiteracy, poor system integration, and data privacy concerns impede widespread adoption in LMICs. Case studies from Ghana, China, and Ethiopia illustrate these devices' potential and challenges in resource-limited settings. Policy interventions, such as public-private partnerships, subsidies, simplified interfaces, and digital literacy programs, are essential to overcome these obstacles. Furthermore, integrating wearable data into national health systems and leveraging artificial intelligence can improve individualised care and long-term outcomes. As mobile phone use increases in LMICs, coupling wearables with mHealth platforms could further empower self-management. With targeted investments and regulatory support, wearable technologies can be pivotal in advancing equitable, proactive, and data-driven diabetes care across underserved populations.