1912-LB: Quantifying Environmental Waste from Diabetes Devices in the U.S.
Authors: TIAN TIFFANY , AARON RACHEL , KLONOFF DAVID C. , AHN DAVID , PETERS ANNE L. , PHILIS-TSIMIKAS ATHENA , SHAH VIRAL N. , HERNDON EMILY G. , LI CHENGDONG , YANG YIJIONG , WANG JING 
Published: June 2024

Introduction: In the U.S. in 2018, the average person generated 66.68 kg of waste/month. With 3.9 million continuous glucose monitor (CGM) users and 745,000 insulin pump users in the U.S. in 2023, diabetes devices may contribute significantly to that amount. Objective: To quantify the environmental waste of diabetes devices.
Methods: Adults with diabetes using CGMs and either insulin pumps or multiple daily injections (MDI, ≥3 injections/day) were enrolled in a prospective observational study. At baseline, demographic information and challenges of waste disposal were collected. Participants completed daily surveys for 30 days detailing the types and amounts of diabetes-related waste discarded. Waste amounts were calculated using weights from manufacturers, medical supply stores, or Amazon. Waste items were CGM sensors, transmitters, applicators, and readers; insulin pumps and bottles; syringes/needles; blood glucose test strips and meters; ketone meters; lancets; and alcohol wipes.
Results: Participants from the U.S. with T1D (N=38) and T2D (N=1) on MDI (N=5) or pumps (N=34) with ≥28 days of data were included. Participants were mostly female (64%), White (82%), educated (90% with bachelor’s degree or higher), &lt;65 years old (79%), privately insured (82%), and living in suburban/urban areas (90%). The average monthly waste was 1.197 kg for pump users and 0.599 kg for MDI users. Other waste items among all participants not included in the monthly waste were printed manuals (120 pieces); packaging (993 pieces); skin care supplies (28 pieces); tape/overpatches (261 pieces); batteries (14 pieces); and sharps containers (2). Common frustrations were excessive packaging (69%) and lack of recycling mechanisms (62%). Diabetes products account for 1-2% of an individual’s household waste, and insulin pumps and related devices contribute to 10.7 million kg of waste/year.
Conclusion: Our study supports the need to optimize use of recyclable materials, reduce waste, and improve recycling methods for diabetes devices.

Disclosure
T. Tian: None. R. Aaron: None. D.C. Klonoff: Consultant; Afon Technology Ltd, Better Therapeutics, Inc, Glucotrack, LIfecare, Nevro Corp., Novo Nordisk, Samsung, Thirdwayv Inc. D. Ahn: Speaker's Bureau; Abbott, Insulet Corporation, Ascensia Diabetes Care. Advisory Panel; Ascensia Diabetes Care. Speaker's Bureau; Xeris Pharmaceuticals, Inc., Novo Nordisk, Lilly Diabetes. Advisory Panel; Lilly Diabetes. Speaker's Bureau; MannKind Corporation. A.L. Peters: Advisory Panel; Lilly Diabetes, Vertex Pharmaceuticals Incorporated, Medscape. Research Support; Abbott, Insulet Corporation. A. Philis-Tsimikas: Advisory Panel; Dexcom, Inc., Lilly Diabetes, Novo Nordisk, Sanofi, Medtronic, Bayer Inc. V.N. Shah: Consultant; Dexcom, Inc., Insulet Corporation. Research Support; Insulet Corporation. Advisory Panel; Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Sanofi, Medscape. Consultant; embecta, Tandem Diabetes Care, Inc. C. Li: None. Y. Yang: None. J. Wang: None.