Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Apr;58(4):401-410.
doi: 10.1007/s00592-020-01589-3. Epub 2020 Aug 13.

Effects of real-time continuous glucose monitoring in type 1 diabetes: a meta-analysis of randomized controlled trials

I Dicembrini #  1   2 , C Cosentino #  1 , M Monami  1 , E Mannucci  1   2 , L Pala  3
Affiliations
Meta-Analysis

Effects of real-time continuous glucose monitoring in type 1 diabetes: a meta-analysis of randomized controlled trials

I Dicembrini et al. Acta Diabetol. 2021 Apr.

Abstract

Aims: Self-monitoring of blood glucose (SMBG) represented a major breakthrough in the treatment of type 1 diabetes. The aim of the present meta-analysis is to assess the effect of continues glucose monitoring (CGM) and flash glucose monitoring (FGM), on glycemic control in type 1 diabetes.

Materials and methods: The present analysis includes randomized clinical trials comparing CGM or FGM with SMBG, with a duration of at least 12 weeks, identified in Medline or clinicaltrials.gov. The principal endpoint was HbA1c at the end of the trial. A secondary endpoint was severe hypoglycemia. Mean and 95% confidence intervals for HbA1c and Mantel-Haenzel odds ratio [MH-OR] for severe hypoglycemia were calculated, using random effect models. A sensitivity analysis was performed using fixed effect models. In addition, the following secondary endpoints were explored, using the same methods: time in range, health-related quality of life, and treatment satisfaction. Separate analyses were performed for trials comparing CGM with SMBG, and those comparing CGM + CSII and SMBG + MDI and CGM-regulated insulin infusion system (CRIS) and CSII + SMBG.

Results: CGM was associated with a significantly lower HbA1c at endpoint in comparison with SMBG (- 0.24 [- 0.34, - 0.13]%); CGM was associated with a significantly lower risk of severe hypoglycemia than SMBG. Treatment satisfaction and quality of life were not measured, or not reported, in the majority of studies. FGM showed a significant reduction in the incidence of mild hypoglycemia and an increased treatment satisfaction, but no significant results are shown in HbA1c. CGM + CSII in comparison with SMBG + MDI was associated with a significant reduction in HbA1c. Only two trials with a duration of at least 12 weeks compared a CRIS with SMBG + CSII; HbA1c between the two treatment arms was not statistically significant (difference in means: - 0.23 [- 0.91; 0.46]%; p = 0.52).

Conclusion: GCM compared to SMBG has showed a reduction in HbA1c and severe hypoglycemia in patient with type 1 diabetes. The comparison between CGM + CSII and SMBG + MDI showed a large reduction in HbA1c; it is conceivable that the effects of CSII + CGM on glycemic control additives. The only comparison available between FGM and SMBG was conducted in patients in good control.

Keywords: Continuous glucose monitoring; Flash glucose monitoring; Type 1 diabetes.

PubMed Disclaimer

References

    1. Nathan DM, Genuth S, Lachin J et al (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329(14):977–986. https://doi.org/10.1056/nejm199309303291401 - DOI - PubMed
    1. Zimmerman BR (1994) Glycaemia control in diabetes mellitus. Towards the normal profile? Drugs 47(4):611–621. https://doi.org/10.2165/00003495-199447040-00005 - DOI - PubMed
    1. Benkhadra K, Alahdab F, Tamhane S et al (2017) Real-time continuous glucose monitoring in type 1 diabetes: a systematic review and individual patient data meta-analysis. Clin Endocrinol (Oxf) 86(3):354–360. https://doi.org/10.1111/cen.13290 - DOI
    1. Floyd B, Chandra P, Hall S et al (2012) Comparative analysis of the efficacy of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes mellitus. J Diabetes Sci Technol 6(5):1094–1102. https://doi.org/10.1177/193229681200600513 - DOI - PubMed - PMC
    1. Langendam M, Luijf YM, Hooft L, Devries JH, Mudde AH, Scholten RJ (2012) Continuous glucose monitoring systems for type 1 diabetes mellitus. Cochrane Database Syst Rev 1:Cd008101. https://doi.org/10.1002/14651858.cd008101.pub2 - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources