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The evolution of technologies to manage diabetes has led to improvements in patient adherence, technique, and monitoring. Insulin pens, for example, have distinct advantages over vials and syringes; they allow for more accurate dosing, improved adherence, less injection site pain, and greater patient satisfaction (1,2). As the population with diabetes grows internationally, second-generation insulin pens have been engineered with USB or Bluetooth features to enable closer monitoring of pharmacotherapy. Similarly, many devices for self-monitoring of blood glucose have also become integrated with Bluetooth to enable wireless transmission of data to a smartphone. As of 2016, the smart insulin pen market was valued at $59 million and is expected to increase to $123 million by 2023 in Latin America, the Middle East, and Africa (3). One report predicts that Europe will have the greatest smart insulin pen market growth, bringing in more than $2 million by 2027, based in part on high current utilization of such pen devices. The trend toward increased use of smart insulin pens can also be seen in North America; in fact, the same report estimates that, by 2027, the North American smart insulin pen market will have a continuous annual growth rate of 26.7% (4). The emergence of new technologies such as smart insulin pens, caps, attachments, and virtual platforms can help both patients and health care providers (HCPs) overcome problems such as poor insulin adherence, incorrect insulin initiation and titration, and medication errors. Adoption of such new devices may increase even further if clinical trials can show long-term cost-effectiveness (5). This review highlights the technologies now available on the market in the United States and internationally that are designed to improve insulin administration. A comprehensive literature review was conducted using manufacturer websites, press releases, commercial data resources, educational and training tools, …