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Review
. 2012 Sep 1;6(5):1094-102.
doi: 10.1177/193229681200600513.

Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus

Baraka Floyd  1 , Prakash Chandra, Stephanie Hall, Christopher Phillips, Ernest Alema-Mensah, Gregory Strayhorn, Elizabeth O Ofili, Guillermo E Umpierrez
Affiliations
Review

Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus

Baraka Floyd et al. J Diabetes Sci Technol. .

Abstract

Background: Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM) have been proven effective in improving hemoglobin A1c (HbA1c) and in reducing hypoglycemia in patients with type 1 diabetes mellitus (T1DM). It is not clear, however, if CGM provides further efficacy and safety benefits beyond SMBG in the management of T1DM.

Methods: MEDLINE (1966-November 2009), COCHRANE REGISTRY (all years), and EMBASE (1980-November 2009), and article bibliographies were searched for randomized controlled trials (RCTs) investigating the use of CGM in patients with T1DM, with clinical outcomes, including HbA1c and hypoglycemia and/or hyperglycemia.

Results: Fourteen RCTs met eligibility criteria [n = 1188 patients, 97.4% with T1DM, age 29.0 ± 14.3 years, diabetes duration 11.7 ± 7.0 years, and baseline HbA1c 8.3 ± 0.8% (mean ± standard deviation)]. Compared with SMBG, the use of CGM was associated with a greater reduction in HbA1c [-0.3% (confidence interval: 0.4, -0.2), p < .0001]. The number of hypoglycemic events was not significantly different between the CGM and SMBG groups (0.52 ± 0.52 versus 0.52 ± 0.63 events/day, p = .5), but duration of hypoglycemia was shorter for the CGM group (75 ± 39 versus 89 ± 19 min/day), with an incremental reduction of hypoglycemia duration of -15.2 min/day, p < .0001. Continuous glucose monitoring also resulted in a shorter duration of hyperglycemia than SMBG (172 ± 125 versus 217 ± 152 min/day, p = .04).

Conclusions: The use of CGM is associated with improvement in metabolic control in T1DM, with significant short- and long-term reductions in HbA1c and reduction in the duration of periods of hypoglycemia and hyperglycemia versus SMBG.

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Figures

Figure 1.
Figure 1.
Study selection process
Figure 2.
Figure 2.
Forrest plot for changes in HbA1c (%) from baseline to end of study among different studies
See this image and copyright information in PMC

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