The effect of continuous subcutaneous glucose monitoring (CGMS) versus intermittent whole blood finger-stick glucose monitoring (SBGM) on hemoglobin A1c (HBA1c) levels in Type I diabetic patients: A systematic review

Chetty, V. Tony; Al-Mulla, Arif; Odueyungbo, Adefowope; Thabane, Lehana

doi:10.1016/j.diabres.2008.02.014

Cited by 80 publications

(58 citation statements)

References 32 publications

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“…A systematic review of trials of the non-real-time CGM system device suggests that it does not lead to significantly lower Hb A 1c values compared with SMBG (149 ). In 2008, a large 26-week randomized trial of 322 type 1 diabetes patients showed that adults Ն25 years of age who used intensive insulin therapy and real-time CGM experienced a 0.5% reduction in Hb A 1c , from approximately 7.6% to 7.1% (approximately 60 to 54 mmol/ mol), compared with the usual intensive insulin therapy with SMBG (150 ).…”

Section: Gppmentioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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Section: Gppmentioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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“…5,6,8,14 Comparison studies on the efficacy and clinical benefits of CGM devices and SMBG have produced mixed results, in part, due to small sample size and variability across studies, including differences in age of subjects, type of CGM utilized (retrospective versus real time), and duration of follow-up. Two previous meta-analyses reported no significant difference in improving glycemic control between CGM and SMBG, 15,16 with one focused solely on T1DM 16 while the other was limited to retrospective data because it was performed prior real-time CGM availability. 15 Accordingly, this meta-analysis aims to determine (1) overall efficacy and safety of retrospective and real-time CGM and SMBG and (2) differences in glycemic control between real-time and retrospective CGM patients with type 1 diabetes mellitus (T1DM) across the age continuum.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

Floyd

Prakash

Hall

et al. 2012

J Diabetes Sci Technol

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“…According to our previous meta-analysis, randomized controlled trials (RCTs) using CGMS in a retrospective way compared with SBGM did not show significant reduction in HbA1c in type 1 diabetic patients (5,6). Real-time CGM (RT-CGM) provides a new dimension to diabetes management.…”

Section: Introductionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials

Szypowska

Ramotowska

Dżygało

et al. 2012

European Journal of Endocrinology

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Objective: Real-time continuous glucose monitoring (RT-CGM) provides detailed information on glucose patterns and trends, thus allowing the patients to manage their diabetes more effectively. Design: The aim of this study was to explore the potential beneficial effects of the use of RT-CGM on diabetes management compared with self blood glucose measurement (SBGM) in patients with type 1 diabetes mellitus (T1DM), by means of a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: MEDLINE, EMBASE, and the Cochrane Library were searched through by two independent investigators for RCTs concerning the use of RT-CGM in patients with T1DM. Only studies with a similar insulin regimen in the experimental and control groups were included in the analysis. Results: Seven RCTs (nZ948) met the inclusion criteria. Combined data from all studies showed better HbA1c reduction in subjects using RT-CGM compared with those using SBGM (mean difference (MD) K0.25; 95% confidence interval (95% CI): from K0.34 to K0.17; P!0.001). Patients treated with insulin pump and RT-CGM had a lower HbA1c level compared with subjects managed with insulin pump and SBGM (four RCTs, nZ497; MD K0.26; 95% CI: from K0.43 to K0.10; PZ0.002). The benefits of applying RT-CGM were not associated with an increasing rate of major hypoglycemic episodes. The use of RT-CGM for over 60-70% of time was associated with a significant lowering of HbA1c. Conclusions: RT-CGM is more beneficial than SBGM in reducing HbA1c in patients with type 1 diabetes. Further studies are needed to evaluate the efficacy of this system in the pediatric population, especially in very young children.

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The effect of continuous subcutaneous glucose monitoring (CGMS) versus intermittent whole blood finger-stick glucose monitoring (SBGM) on hemoglobin A1c (HBA1c) levels in Type I diabetic patients: A systematic review

Cited by 80 publications

References 32 publications

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Comparative Analysis of the Efficacy of Continuous Glucose Monitoring and Self-Monitoring of Blood Glucose in Type 1 Diabetes Mellitus

MANAGEMENT OF ENDOCRINE DISEASE: Beneficial effect of real-time continuous glucose monitoring system on glycemic control in type 1 diabetic patients: systematic review and meta-analysis of randomized trials

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