ISPAD Newsletter - May 2026

ISPAD's May Newsletter is now available with exciting news. Click here to access to our latest news:

President's Message:

This was originally a song from Sesame Street where Kermit affirms being comfortable with his own identity. The phrase has been subsequently re-purposed to capture the challenges of environmentalism.

Physical waste in health care is a significant issue that is continuously growing. Health care products consume energy in production and disposal and have a significant impact on the environment.  The WHO estimate that every year 16 billion injections are given around the world. Each of these generates hazardous and non-hazardous waste. Ambulant diabetes care with an emphasis on single-use devices and growing reliance on consumable technology is a significant contributor to medical waste. It is estimated that worldwide 150-200 million people use insulin daily with the attendant administration products. Insulin pumps and pens in the US have been calculated to generate waste equivalent to 2% of household waste by weight. Extrapolations of prospectively collected data in Germany indicated that 1.2 billion pieces of diabetes technology waste are generated per year nationwide. Given that much of this happens at home, most generated waste is unseen by diabetes health care teams and thus perhaps out of mind.

The Diabetes Technology Society (DTS) has taken a lead in identifying and quantifying diabetes-related medical waste. In particular, David Klonoff and Lutz Heinemann have published several recent papers highlighting the specific issues and regulatory requirements required to solve them. The DTS has gone so far as to change their logo’s colour from red to green to highlight their commitment to improving the environmental footprint of diabetes care. They make the strong point- “Probably the first necessary change for improved waste disposal is to change our own mindset.”.

We on the ISPAD Executive Board strongly agree with this sentiment. For several years ISPAD Conferences have been green initiatives being paper-free and plastic-free. 

It’s not easy being green. The convergence of two critical areas- health care and the environment, can be testing when one is seemingly at the expense of the other. Despite the challenges, we should not be dissuaded from trying to reducing waste in diabetes care. In terms of things that ultimately become waste, our colleagues in industry produce it, our patients use it and we prescribe it. We are equal partners in dealing with this problem.  As a society we should be advocating for sustainable practices in diabetes product lifecycles.  We should not allow ourselves to be reduced to inertia by the status quo and put it in the “too hard basket”. It is not an easy problem to fix, but the sooner we engage with it the sooner we will start to see change. Let’s be proactive and positive. Accordingly, we would like to announce the formation of a new ISPAD Special Interest Group (SIG) headed by Dr Mary White and Dr Steven James to assess the published evidence and produce guidelines to increase recycling and reduce waste. If this is of interest to you as an ISPAD member, please reach out via the usual channels.

I leave Kermit (and Babs) with the last word on matching hopes with reality:

On a related note, this newsletter includes an inspiring story of where hope and reality have coalesced. Last year’s ISPAD’s prize-winner for Innovation in Pediatric Diabetes Care, Dr Sujoy Ghosh has turned dreams into actuality in terms of structured model of care for children across India- 800 clinics across all India. This is an inspiring story of how a pilot program supported by Life for a Child, UNICEF, the Indian Health Ministry and ISPAD has resulted in real clinical change. Make sure you read this great story!

Best to all,

Fergus