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Conventional self-monitoring of blood glucose (SMBG) for diabetes care relies on finger-stick testing, which many patients find burdensome.
In adults suffering from type 2 diabetes, both CGM and isCGM reduce HbA1c. IsCGM additionally improves user satisfaction, although both are associated with an increased risk of adverse events.
Conventional self-monitoring of blood glucose (SMBG) for diabetes care relies on finger-stick testing, which many patients find burdensome. Continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) yield more convenient and detailed insights, potentially improving management in people with type 2 diabetes (T2D). This review explored the clinical benefits and potential drawbacks of CGM and isCGM when compared with standard care or SMBG in T2D.
A systematic search was performed in Cochrane Library, Web of Science, Embase, MEDLINE, and reference lists. Eligible studies were randomized controlled trials (RCTs) that compared at least two interventions over a minimum of 8 weeks in adults with T2D. Interventions encompassed real-time or retrospective CGM, short- or long-term CGM, isCGM, and SMBG, with outcomes related to glycemic control and other relevant measures. A structured data collection form was employed to extract study characteristics, including author, year, design, participant baseline data, intervention details, and reported outcomes.
In total, 26 RCTs (17 evaluating CGM and 9 evaluating isCGM) with a total of 2,783 volunteers were included. Among them, 632 used CGM when compared with 514 receiving usual care/SMBG, and 871 used isCGM compared with 766 receiving usual care/SMBG. CGM lowered glycated hemoglobin (HbA1c; mean difference -0.19%) and reduced the glycemic medication effect score (-0.67).
However, CGM was linked with lower user satisfaction (-0.54) and a higher risk of adverse events (RR 1.22). IsCGM lowered HbA1c by -0.31%, improved user satisfaction (0.44), enhanced CGM-related metrics, and was also linked to a heightened risk of adverse events (RR 1.30). Neither CGM nor isCGM showed significant effects on body composition, blood pressure, or lipid profiles.
Both CGM and isCGM led to modest but remarkable reductions in HbA1c in patients with T2D. IsCGM additionally improved patient satisfaction, whereas CGM did not. The influence of these technologies on blood pressure, body composition, and lipid profiles remained uncertain. Both devices, however, carried a higher probability of adverse events.
Diabetes Care
Efficacy and Safety of Continuous Glucose Monitoring and Intermittently Scanned Continuous Glucose Monitoring in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Interventional Evidence
Samuel Seidu et al.
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