Continuous glucose monitoring improves control in T1D and T2D

  • Maiorino MI & al.
  • Diabetes Care
  • 1 May 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Continuous glucose monitoring (CGM) leads to improved glycemic control in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D).
  • It extends time spent in target range (TIR) and reduces time spent in hypoglycemia (180 mg/dL).

Why this matters

  • No previous study has assessed effects of available CGM systems on TIR, hypoglycemia, hyperglycemia, and glycemic variability.

Study design

  • Meta-analysis of 15 randomized controlled trials lasting 12-36 weeks with 18 comparisons of CGM (n=1308) vs usual care (n=1153), including some adults with T2D and adults and children with T1D.
  • Funding: None.

Key results

  • CGM vs control strategies:
    • HbA1c was lower: −0.17% (95% CI, −0.29% to −0.06%).
    • Increased TIR: by 70.74 minutes (95% CI, 46.73-94.76).
  • TIR increases (95% CIs) by CGM type: 
    • Real-time CGM: 83.49 (52.68-114.30) minutes.
    • Intermittent CGM: 53.91 (28.54-79.27) minutes.
    • Sensor-augmented pump: 37.10 (0.74-73.45).
  • Results were consistent based on diabetes type, background therapy, and reason for CGM use.
  • Compared with controls, with CGM there were significant reductions in time spent with blood glucose:
    • >180 mg/dL: −30.26 (95% CI, −58.15 to −2.38) minutes.

Limitations

  • High heterogeneity with most study outcomes.
  • All studies industry-sponsored, short, open-label design.