Systematic Review of Randomized Controlled Trials Evaluating Glycemic Efficacy and Patient Satisfaction of Intermittent-Scanned Continuous Glucose Monitoring in Patients with Diabetes

Diabetes Technol Ther. 2020 May;22(5):337-345. doi: 10.1089/dia.2019.0345.

Abstract

Introduction: Intermittent-scanned continuous glucose monitoring (isCGM) has the ability to allow for greater personalization of diabetes self-management. The purpose of this systematic review is to provide an updated analysis of the efficacy and patient satisfaction of isCGM in patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). Methods: A research librarian searched PubMed, EMBASE, and Cochrane Library using keywords and subject headings to identify studies assessing efficacy and use of isCGMs in patients with T1DM and T2DM. Results: Nine randomized controlled trials (RCTs) involving patients with T1DM and T2DM using isCGM were included. Based on available RCT evidence investigating isCGM in patients with diabetes, isCGM may lead to a small decrease hemoglobin A1c (HbA1c) in certain subgroups of patients with uncontrolled T2DM (those using multiple daily insulin injections and aged 65 years or younger). Patients with uncontrolled T1DM using insulin may also benefit from isCGM, when combined with a structured diabetes education program. Evidence is mixed regarding isCGM impact on improving time in glycemic range, glycemic variability, and hypoglycemia. isCGM has demonstrated greater patient satisfaction and lower diabetes distress compared with usual care. Conclusions: isCGM may lead to improvements in HbA1c in certain subgroups of patients. Additional benefit with isCGM on time in glycemic range, glycemic variability, and hypoglycemia is unclear at this time. Future clinical trials are warranted to investigate the role of isCGM in patients with uncontrolled T2DM using insulin and oral antidiabetic drugs.

Keywords: Continuous glucose monitoring; Diabetes technology; Flash glucose monitoring; Intermittently scanned glucose monitoring; Real-time glucose monitoring.

Publication types

  • Systematic Review

MeSH terms

  • Blood Glucose*
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Glycemic Control*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Patient Satisfaction*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin