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Bengaluru, October 28, 2025 — After watching his grandfather struggle to remember insulin injections, 18-year-old Agastya Karthikeya Sivanandan of Inventure Academy has developed a patent-pending “AKSmart Pen,” a smart insulin pen designed to track dose and timing and issue audible alerts to reduce missed or mistimed doses in older adults with diabetes. The project, already recognized with a CREST Gold Award from the British Science Association and reported by his school community, highlights a user-first approach to adherence for seniors managing a complex chronic condition while maintaining autonomy.
Why this matters
Older adults with diabetes face higher rates of unrecognized cognitive impairment and dementia, which can make complex self-care tasks like insulin dosing and timing difficult, increasing risks of hypoglycemia, hyperglycemia, and related complications. Authoritative standards emphasize tailoring diabetes care for seniors to reduce treatment burden and prioritize safety, underscoring the need for simple, reliable tools that support daily routines without undermining independence. Missed or mistimed insulin doses are consistently linked to worse glucose control, with reviews and clinician surveys associating even a few missed basal doses per month with clinically meaningful deterioration in HbA1c and quality of life.
The device
Agastya’s “AKSmart Pen” tracks dosage and timing and emits an audible alert if not docked for up to five minutes, a feature intended to reduce missed doses and help users quickly locate the pen if misplaced, particularly in time-sensitive situations. The design emphasizes straightforward user experience for elderly patients, a demographic often overlooked in device design despite the growing burden of diabetes in older age groups globally. The project has earned a CREST Gold Award and has been described as patent-pending; EdexLive reports that his name was recently listed in India’s Intellectual Property journal, though independent verification of the IP listing is still pending from official records.
Expert view
“Connected pens can remind users of dose timing, warn against double injections, and display recent insulin doses—particularly useful for older people who are a little forgetful,” notes diabetes technology expert Lutz Heinemann, PhD, in a 2024 commentary on smart pens. The American Diabetes Association’s technology guidance similarly recognizes that connected insulin pens and pen caps help with real-time dosing and enable clinicians to review insulin patterns retrospectively to optimize care. Education leaders in diabetes care (ADCES) also highlight that smart pens can distinguish prime versus therapy doses and accurately track “insulin on board,” supporting safer decisions between injections.
Context and current solutions
Smart insulin pens, including widely used systems like InPen and NovoPen 6/Echo Plus, pair hardware with apps to calculate and track doses, set reminders, log injections automatically, and share reports with clinicians—bringing some pump-like benefits to people on multiple daily injections at lower cost. Real-world data from connected pen users show missed basal doses correlate with higher mean glucose, worse glucose management indicators, and lower time in range, indicating that better tracking and reminders can translate into measurable glycemic gains. Broader reviews of connected insulin pens suggest potential improvements in time-in-range and reductions in hypoglycemia, though randomized trials remain limited and user training, digital literacy, and data-sharing workflows are critical to success.
The adherence problem in older adults
ADA’s Older Adult Standards of Care emphasize regular assessment of cognitive, functional, and social domains and recommend simplifying regimens where possible to improve safety and adherence. Cognitive decline, visual impairment, and dexterity issues can lead to missed doses or dosing errors, pointing to the value of tactile, audible, and clear feedback designs in any tool meant for seniors. A systematic review and meta-analysis found that insulin adherence—measured by prescription fills—was associated with a mean HbA1c reduction of approximately 0.5% between adherent and nonadherent groups, reinforcing why practical adherence supports matter for long-term outcomes.
Patient voice and autonomy
“What started as a personal effort has grown into a device with practical application,” Agastya says, describing a goal to let older users remain “in charge of their health without feeling dependent on others,” after seeing his grandfather lose confidence due to memory lapses. The AKSmart Pen’s simple alert and docking concept aims to balance safety with dignity—offering a nudge rather than surveillance—consistent with geriatric diabetes guidance that encourages minimizing treatment burden while preserving independence. As Agastya moves toward broader validation, the focus on respectful autonomy reflects an important shift in design thinking for chronic disease tools in late life.
Evidence and limitations
Evidence supports that connected pens can reveal missed injections and improve data-driven care; however, most findings are observational, and device benefits depend on correct setup, ongoing engagement, and integration with clinical workflows. Key limitations to consider include the need for usability testing in populations with varying levels of cognitive impairment, hearing loss (for audible alerts), and digital literacy, as well as evaluation across diverse care settings and insulin regimens. Regulatory clearance, human factors testing, interoperability with glucose meters or CGMs, and robust data privacy protections will be essential for any wide-scale rollout of a new smart pen.
Public health implications
Diabetes prevalence is rising globally—with an estimated 589 million adults affected in 2024—and older age groups carry particularly high prevalence, making adherence support for seniors a meaningful public health target. Tools that reduce missed or mistimed doses may help curb emergency visits and hospitalizations related to hypo- and hyperglycemia, but equitable access, affordability, and training for caregivers and clinicians will determine real-world impact at scale. In low- and middle-income countries, where most people with diabetes now live, low-cost, easy-to-use devices with offline functionality and minimal maintenance may be especially valuable.
Practical takeaways for readers
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If using insulin, set clear routines and reminders; connected pens or pen caps can log doses and prompt timing, which may help reduce errors, especially for those on multiple daily injections.
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Discuss any new device with your care team to ensure correct dosing settings, safe injection technique, and realistic integration with your daily life and supports at home.
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For caregivers, consider tools with audible/visual cues and simple docking or storage—features that can help with memory lapses without undermining the person’s independence.
What’s next for AKSmart Pen
Agastya plans further clinical validation and development, while continuing public science communication through his “CGM Challenge” social media segments that demonstrate diet and lifestyle effects on glucose in real time. As the device advances, independent usability studies in older adults, human factors assessments, and comparative evaluations against existing smart pens will be critical milestones before broader adoption. Recognition through the CREST Gold Award underscores the initiative’s promise, but health-system integration and rigorous testing will ultimately determine its role in geriatric diabetes care.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
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