What is holding back glucometer use? -A comparative study of rural and urban India

Background: Self-monitoring of blood glucose (SMBG) is associated with better glycemic control. There have been significant technological advances in blood glucose monitoring in the recent past, but the wider acceptance of these technologies is still debatable. Aim: This study investigates the adoption of glucometers and the extent of the use of features in rural and urban India. Methods: The study uses Bass Model to predict the diffusion of innovation (DOI). Mathematical modeling was used to determine the stage of adoption (using 5-stage of DOI) and the Chi-Square test was used for examining the relationship between depth of implementation (extent of use) and place of residence. Results: The result of the study suggests that glucometer diffusion of innovation has passed the initial hurdle (chasm) in the urban population and is in the late majority. However, for rural respondents, the adoption of glucometers has just passed the chasm and falls under the early majority stage. The diffusion of innovation of combined rural and urban populations has just entered the late majority zone in 2022. The study suggests that a significant number of people with diabetes are still not using a glucometer and discusses the socio-economic issue related to this phenomenon. The utilization of the potential of a glucometer in SMBG falls under the localized shallow implementation category (not using advanced features). Conclusions: The study suggests that the adoption of glucometer has just passed the initial hurdle in rural India, where two-thirds of the Indian population lives. Furthermore, the adoption of advanced glucometers is low among users.