India’s rapidly expanding digital healthcare ecosystem is failing to reach millions of people living with diabetes due to persistent digital inequalities, according to a new study published in BMC Public Health. The research highlights that older adults, rural populations, women and economically disadvantaged communities continue to face significant barriers in accessing digital tools designed to improve diabetes management and outcomes.

The findings come from the DIG-EQUITY study, which examined the experiences of people with diabetes, caregivers, healthcare professionals, policymakers and community organizations across urban and rural regions of Tamil Nadu. Using a multi stakeholder approach, researchers assessed how individual, social, institutional, infrastructural and policy related factors collectively influence equitable access to digital healthcare services.

India is home to one of the world’s largest diabetes populations, with the International Diabetes Federation (IDF) estimating that more than 101 million adults in the country are living with diabetes. As healthcare providers increasingly adopt telemedicine platforms, mobile health applications, wearable devices and remote monitoring technologies, digital health is being viewed as a key tool for improving disease management and reducing healthcare costs. However, the study suggests that access to these innovations remains uneven.

Researchers found that older adults face some of the greatest challenges in utilizing digital healthcare services. Many require assistance from family members to schedule teleconsultations, access laboratory reports or navigate mobile health applications. Age-related issues such as impaired vision, hearing difficulties and lower digital confidence further limit their ability to benefit from technology enabled healthcare.

The study also identified substantial geographic disparities. Urban residents generally have better access to smartphones, internet connectivity and digital healthcare services, while many rural communities continue to struggle with unreliable networks, limited digital infrastructure and shared device usage. Financial constraints were another major barrier, with the costs of smartphones, internet access, wearable technologies and continuous glucose monitoring devices placing digital healthcare beyond the reach of many low income households.

Importantly, researchers emphasized that digital access alone is insufficient. Digital literacy remains a critical determinant of healthcare utilization, as many individuals lack the skills needed to effectively use telemedicine platforms and health applications even when technology is available.

To address these challenges, the study recommends expanding digital literacy programmes, improving rural digital infrastructure, developing more user-friendly technologies and strengthening caregiver support systems. It also highlights the importance of building trust through stronger data privacy protections, supported by frameworks such as the Digital Personal Data Protection Act, 2023 and the proposed DPDP Rules.

The researchers concluded that while digital healthcare has the potential to transform diabetes management in India, meaningful progress will depend on ensuring that inclusion and accessibility advance alongside technological innovation. Without targeted interventions, existing digital inequalities could continue to widen healthcare disparities among vulnerable populations.