Flash Glucose Monitoring and Patient Satisfaction: A Meta-Review of Systematic Reviews

Abstract

Flash glucose monitoring (FGM) systems have been suggested to have clinical beneficial effects in patients with diabetes mellitus, although their improvements in terms of quality of life (QoL) and patients’ satisfaction are not always addressed or are considered a secondary outcome. Thus, the aim of this meta-review is to establish the benefits of FGM in terms of patients’ satisfaction and QoL in both type 1 and type 2 diabetes patients using evidence from past systematic reviews and meta-analyses. Major databases were searched for systematic reviews (with or without meta-analyses) that assessed the satisfaction or QoL of type 1 or 2 diabetes patients using FGM compared with other glucose monitoring systems. The quality of the included systematic reviews was addressed with the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) tool. Six systematic reviews (including two meta-analyses) were included in the meta-review. Evidence suggests that FGM systems seem to improve patients’ satisfaction and QoL compared with self-monitoring of blood glucose, although the high variability in the measurement tools, the clinical significance and the quality of the systematic reviews included do not allow us to state FGM benefits with any certainty. Further research, including high-quality randomised clinical trials, differentiating the needs of both type 1 and type 2 diabetes patients and focusing on psychosocial benefits for these patients is needed to optimise clinical decisions between patients and professionals by developing the right health technology assessment for FGM systems.

Using flash glucose monitoring in pregnancies in routine care of patients with gestational diabetes mellitus: a pilot study

“…The data collected correlates with the results in the study by Kramer et al [31] in which satisfaction was analyzed after conversion from SMBG to FGM in patients and female patients with type 1 diabetes, they also used the DTSQc for measuring patient's satisfaction. Similar results were presented in a meta-analysis of the relationship between FGM and patient satisfaction, finding an increase in satisfaction based on the DTSQ [32]. The more frequently perceived hyper-and hypoglycemias in combination with a better understanding of the disease suggest that the patients are more sensitized to hypo-and hyperglycemias and can better classify reactions of the body due to higher insight into the disease.…”

Expanding the Role of Continuous Glucose Monitoring in Modern Diabetes Care Beyond Type 1 Disease

“…Thus, using CGM compared to SMBG alone is associated with more time in range (TIR) with a glucose level of 70–180 mg/dL, less time above range (TAR) in hyperglycemia with a glucose level greater than 180 mg/dL, and less time below range (TBR) in hypoglycemia with a glucose level lower than 70 mg/dL, including nocturnal hypoglycemia, in people with T1DM or T2DM [ 23 – 25 , 32 ]. CGM users also have less glucose variability, improved quality of life [ 33 – 35 ], and have fewer hospital admissions for acute diabetes events such as diabetic ketoacidosis (DKA) and severe hypoglycemia [ 36 – 40 ].…”

Summary of clinical investigation plan for The DIATEC trial: in-hospital diabetes management by a diabetes team and continuous glucose monitoring or point of care glucose testing – a randomised controlled trial

“…CGM measures glucose levels every 1-15 minutes, which might more accurately guide the titration of insulin therapy compared to (POC) glucose testing. CGM is commonly used in an out- hospital setting for patients with type 1 diabetes and has revolutionised diabetes management and increased patient satisfaction [ 13 ]. Recently, the COVID-19 pandemic has spurred interest in using in -hospital telemetric CGM to minimise the spread of infectious particles and reduce the usage of personal protection equipment [ 14 ].…”