Effect of Different Glucose Monitoring Methods on Bold Glucose Control: A Systematic Review and Meta-Analysis

Abstract

Objective. To evaluate the effectiveness of different glucose monitoring methods on blood glucose control and the incidence of adverse events among patients with type 1 diabetes mellitus. Methods. Using the method of literature review, the databases PubMed, Cochrane, and Embase were retrieved to obtain relevant research literature, and the selected studies were analyzed and evaluated. This study used Cochrane software RevMan5.4 to statistically analyze all the data. Results. A total of 15 studies were included in this study, including 10 randomized controlled trials and 5 crossover design trials, with a total of 2071 patients. Meta-analysis results showed that continuous blood glucose monitoring (CGM) could significantly reduce the HbA1c level of patients, weighted mean difference WMD = − 2.69 , 95% confidence interval (CI) (-4.25, -1.14), and P < 0.001 compared with self-monitoring of blood glucose (SMBG). Meanwhile, the incidence of severe hypoglycemia in the CGM group was significantly decreased, risk ratio RR = 0.52 , 95% CI 0.35-0.77, and P = 0.001 . However, there was no statistical difference in the probability of diabetic ketoacidosis between CGM and SMBG groups, RR = 1.34 , 95% CI 0.57-3.15, and P = 0.5 . Conclusion. Continuous blood glucose monitoring is associated with lower blood glucose levels than the traditional blood glucose self-test method.

Use of continuous glucose monitors in low‐ and middle‐income countries: A scoping review

“…For example, a recent systematic review of 22 randomized controlled trials in people with T1DM found effects in glycaemic control but they did not find influence of the CGMs on the number of severe hypoglycaemia or diabetic ketoacidosis events, 9 perhaps due to the small number of participants in the included studies. In addition, another systematic review in T1DM subjects with 15 trials (10 RCTs and 5 crossover design trials) reported an effect in decreasing the incidence of severe hypoglycaemia (risk ratio 0.52, 95% CI 0.35–0.77) 10 . Our current scoping review and the previous systematic reviews should be used to design studies that considered long‐term patient‐oriented outcomes and proper sample sizes to have stronger evidence related to CGMs from LMICs.…”

“…In addition, another systematic review in T1DM subjects with 15 trials (10 RCTs and 5 crossover design trials) reported an effect in decreasing the incidence of severe hypoglycaemia (risk ratio 0.52, 95% CI 0.35-0.77). 10 Our current scoping review and the previous systematic reviews should be used to design studies that considered long-term patient-oriented outcomes and proper sample sizes to have stronger evidence related to CGMs from LMICs. Besides, it is important to consider other outcomes such as emotional distress and sleep disruption, that have been previously described in qualitative studies using CGMs or other devices for their diabetes management, 43,44 with the subsequent effect in the quality of life of people with diabetes.…”

“…Empirical evidence suggests using CGMs improves glycaemic control, 9,10 and reduces the risk of complications in comparison to people with diabetes who do not use CGMs 11,12 . As useful as CGMs are, they are not available in many LMICs and even in countries where CGMs are marketed, especially in high‐income countries, there may be inequalities in accessing them 13 .…”

Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2022

“…La monitorización continua de la glucosa en sangre (MCG) puede ser una solución interesante en pacientes con DM2 tratados con múltiples dosis de insulina para mejorar el grado de control glucémico y reducir las hipoglucemias. Un reciente metaanálisis muestra como la MCG se asocia a niveles de glucosa en sangre más bajos (HbA1c -2,69, IC 95% -4,25, -1,14, p < 0,001) que el método tradicional de autotest de glucosa en sangre capilar y la incidencia de hipoglucemia grave se redujo significativamente (RR = 0,52, IC 95%: 0,35-0,77 y p = 0,001 241 . La MCG se valora parámetros diferentes a los empleados en práctica clínica habitual (glucemia, HbA1c), siendo el tiempo en rango el más empleado y se considera buena control un valor de 70% 141 o superior, valor que se ha descrito se aproxima al objetivo tradicional de Hba1c < 7% 242 .…”

Interpretación del monitoreo continuo de glucosa: una visión práctica

“…Se ha posicionado como una tecnología efectiva en el cuidado de los pacientes que viven con diabetes, permitiéndoles alcanzar un control metabólico de calidad (3, 13); siendo una herramienta complementaria a la hemoglobina glicosilada (HbA1c) (4). El uso de MCG se ha asociado con reducciones de HbA1C en niños y adultos, sin incrementar los episodios de hipoglucemia y sin un impacto estadísticamente significativo en la reducción de eventos de cetosis (5,6). El uso de MCG en pacientes con Volumen 10, número 1 de 2023…”