Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis Article Swipe
Milena Jancev
,
Tessa A. C. M. Vissers
,
Frank L.J. Visseren
,
Arianne C. van Bon
,
Erik H. Serné
,
J. Hans DeVries
,
Harold W. de Valk
,
Thomas T. van Sloten
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1007/s00125-024-06107-6
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1007/s00125-024-06107-6
Aims/hypothesis Continuous glucose monitoring (CGM) is increasingly used in the treatment of type 2 diabetes, but the effects on glycaemic control are unclear. The aim of this systematic review and meta-analysis is to provide a comprehensive overview of the effect of CGM on glycaemic control in adults with type 2 diabetes. Methods We performed a systematic review using Embase, MEDLINE, Web of Science, Scopus and ClinicalTrials.gov from inception until 2 May 2023. We included RCTs investigating real-time CGM (rtCGM) or intermittently scanned CGM (isCGM) compared with self-monitoring of blood glucose (SMBG) in adults with type 2 diabetes. Studies with an intervention duration <6 weeks or investigating professional CGM, a combination of CGM and additional glucose-lowering treatment strategies or GlucoWatch were not eligible. Change in HbA 1c and the CGM metrics time in range (TIR), time below range (TBR), time above range (TAR) and glycaemic variability were extracted. We evaluated the risk of bias using the Cochrane risk-of-bias tool version 2. Data were synthesised by performing a meta-analysis. We also explored the effects of CGM on severe hypoglycaemia and micro- and macrovascular complications. Results We found 12 RCTs comprising 1248 participants, with eight investigating rtCGM and four isCGM. Compared with SMBG, CGM use (rtCGM or isCGM) led to a mean difference (MD) in HbA 1c of −3.43 mmol/mol (−0.31%; 95% CI −4.75, −2.11, p <0.00001, I 2 =15%; moderate certainty). This effect was comparable in studies that included individuals using insulin with or without oral agents (MD −3.27 mmol/mol [−0.30%]; 95% CI −6.22, −0.31, p =0.03, I 2 =55%), and individuals using oral agents only (MD −3.22 mmol/mol [−0.29%]; 95% CI −5.39, −1.05, p =0.004, I 2 =0%). Use of rtCGM showed a trend towards a larger effect (MD −3.95 mmol/mol [−0.36%]; 95% CI −5.46 to −2.44, p <0.00001, I 2 =0%) than use of isCGM (MD −1.79 mmol/mol [−0.16%]; 95% CI −5.28, 1.69, p =0.31, I 2 =64%). CGM was also associated with an increase in TIR (+6.36%; 95% CI +2.48, +10.24, p =0.001, I 2 =9%) and a decrease in TBR (−0.66%; 95% CI −1.21, −0.12, p =0.02, I 2 =45%), TAR (−5.86%; 95% CI −10.88, −0.84, p =0.02, I 2 =37%) and glycaemic variability (−1.47%; 95% CI −2.94, −0.01, p =0.05, I 2 =0%). Three studies reported one or more events of severe hypoglycaemia and macrovascular complications. In comparison with SMBG, CGM use led to a non-statistically significant difference in the incidence of severe hypoglycaemia (RR 0.66, 95% CI 0.15, 3.00, p =0.57, I 2 =0%) and macrovascular complications (RR 1.54, 95% CI 0.42, 5.72, p =0.52, I 2 =29%). No trials reported data on microvascular complications. Conclusions/interpretation CGM use compared with SMBG is associated with improvements in glycaemic control in adults with type 2 diabetes. However, all studies were open label. In addition, outcome data on incident severe hypoglycaemia and incident microvascular and macrovascular complications were scarce. Registration This systematic review was registered on PROSPERO (ID CRD42023418005). Graphical Abstract
Related Topics
Concepts
Medicine
Meta-analysis
Type 2 diabetes
Continuous glucose monitoring
Type 1 diabetes
MEDLINE
Diabetes mellitus
Internal medicine
Endocrinology
Law
Political science
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1007/s00125-024-06107-6
- https://link.springer.com/content/pdf/10.1007/s00125-024-06107-6.pdf
- OA Status
- hybrid
- Cited By
- 86
- References
- 31
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4391884989
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4391884989Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1007/s00125-024-06107-6Digital Object Identifier
- Title
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Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysisWork title
- Type
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reviewOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-02-16Full publication date if available
- Authors
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Milena Jancev, Tessa A. C. M. Vissers, Frank L.J. Visseren, Arianne C. van Bon, Erik H. Serné, J. Hans DeVries, Harold W. de Valk, Thomas T. van SlotenList of authors in order
- Landing page
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https://doi.org/10.1007/s00125-024-06107-6Publisher landing page
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https://link.springer.com/content/pdf/10.1007/s00125-024-06107-6.pdfDirect link to full text PDF
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YesWhether a free full text is available
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hybridOpen access status per OpenAlex
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https://link.springer.com/content/pdf/10.1007/s00125-024-06107-6.pdfDirect OA link when available
- Concepts
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Medicine, Meta-analysis, Type 2 diabetes, Continuous glucose monitoring, Type 1 diabetes, MEDLINE, Diabetes mellitus, Internal medicine, Endocrinology, Law, Political scienceTop concepts (fields/topics) attached by OpenAlex
- Cited by
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86Total citation count in OpenAlex
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2025: 64, 2024: 22Per-year citation counts (last 5 years)
- References (count)
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31Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.larger | 286 |
| abstract_inverted_index.micro- | 179 |
| abstract_inverted_index.review | 29, 57, 484 |
| abstract_inverted_index.severe | 176, 385, 406, 471 |
| abstract_inverted_index.showed | 281 |
| abstract_inverted_index.trials | 434 |
| abstract_inverted_index.(isCGM) | 84 |
| abstract_inverted_index.(rtCGM) | 79 |
| abstract_inverted_index.+10.24, | 332 |
| abstract_inverted_index.=0.001, | 334 |
| abstract_inverted_index.=0.004, | 274 |
| abstract_inverted_index.Embase, | 59 |
| abstract_inverted_index.Methods | 52 |
| abstract_inverted_index.Results | 183 |
| abstract_inverted_index.Studies | 98 |
| abstract_inverted_index.control | 21, 45, 452 |
| abstract_inverted_index.effects | 18, 172 |
| abstract_inverted_index.glucose | 3, 90 |
| abstract_inverted_index.insulin | 240 |
| abstract_inverted_index.metrics | 130 |
| abstract_inverted_index.outcome | 467 |
| abstract_inverted_index.provide | 34 |
| abstract_inverted_index.scanned | 82 |
| abstract_inverted_index.scarce. | 480 |
| abstract_inverted_index.studies | 235, 378, 461 |
| abstract_inverted_index.towards | 284 |
| abstract_inverted_index.version | 159 |
| abstract_inverted_index.without | 243 |
| abstract_inverted_index.−1.79 | 307 |
| abstract_inverted_index.−3.22 | 266 |
| abstract_inverted_index.−3.27 | 247 |
| abstract_inverted_index.−3.43 | 216 |
| abstract_inverted_index.−3.95 | 289 |
| abstract_inverted_index.−5.46 | 294 |
| abstract_inverted_index.(+6.36%; | 328 |
| abstract_inverted_index.Abstract | 0, 492 |
| abstract_inverted_index.Cochrane | 156 |
| abstract_inverted_index.Compared | 198 |
| abstract_inverted_index.However, | 459 |
| abstract_inverted_index.MEDLINE, | 60 |
| abstract_inverted_index.PROSPERO | 488 |
| abstract_inverted_index.Science, | 63 |
| abstract_inverted_index.compared | 85, 443 |
| abstract_inverted_index.decrease | 340 |
| abstract_inverted_index.duration | 102 |
| abstract_inverted_index.explored | 170 |
| abstract_inverted_index.incident | 470, 474 |
| abstract_inverted_index.included | 74, 237 |
| abstract_inverted_index.increase | 325 |
| abstract_inverted_index.mmol/mol | 217, 248, 267, 290, 308 |
| abstract_inverted_index.moderate | 228 |
| abstract_inverted_index.overview | 37 |
| abstract_inverted_index.reported | 379, 435 |
| abstract_inverted_index.unclear. | 23 |
| abstract_inverted_index.−0.01, | 371 |
| abstract_inverted_index.−0.12, | 347 |
| abstract_inverted_index.−0.31, | 253 |
| abstract_inverted_index.−0.84, | 358 |
| abstract_inverted_index.−1.05, | 272 |
| abstract_inverted_index.−1.21, | 346 |
| abstract_inverted_index.−2.11, | 222 |
| abstract_inverted_index.−2.44, | 296 |
| abstract_inverted_index.−2.94, | 370 |
| abstract_inverted_index.−4.75, | 221 |
| abstract_inverted_index.−5.28, | 312 |
| abstract_inverted_index.−5.39, | 271 |
| abstract_inverted_index.−6.22, | 252 |
| abstract_inverted_index.Graphical | 491 |
| abstract_inverted_index.addition, | 466 |
| abstract_inverted_index.diabetes, | 15 |
| abstract_inverted_index.diabetes. | 51, 97, 458 |
| abstract_inverted_index.eligible. | 122 |
| abstract_inverted_index.evaluated | 149 |
| abstract_inverted_index.glycaemic | 20, 44, 144, 365, 451 |
| abstract_inverted_index.inception | 68 |
| abstract_inverted_index.incidence | 404 |
| abstract_inverted_index.performed | 54 |
| abstract_inverted_index.real-time | 77 |
| abstract_inverted_index.treatment | 11, 116 |
| abstract_inverted_index.−10.88, | 357 |
| abstract_inverted_index.(−0.31%; | 218 |
| abstract_inverted_index.(−0.66%; | 343 |
| abstract_inverted_index.(−1.47%; | 367 |
| abstract_inverted_index.(−5.86%; | 354 |
| abstract_inverted_index.Continuous | 2 |
| abstract_inverted_index.GlucoWatch | 119 |
| abstract_inverted_index.additional | 114 |
| abstract_inverted_index.associated | 322, 447 |
| abstract_inverted_index.comparable | 233 |
| abstract_inverted_index.comparison | 391 |
| abstract_inverted_index.comprising | 188 |
| abstract_inverted_index.difference | 210, 401 |
| abstract_inverted_index.extracted. | 147 |
| abstract_inverted_index.monitoring | 4 |
| abstract_inverted_index.performing | 165 |
| abstract_inverted_index.registered | 486 |
| abstract_inverted_index.strategies | 117 |
| abstract_inverted_index.systematic | 28, 56, 483 |
| abstract_inverted_index.[−0.16%]; | 309 |
| abstract_inverted_index.[−0.29%]; | 268 |
| abstract_inverted_index.[−0.30%]; | 249 |
| abstract_inverted_index.[−0.36%]; | 291 |
| abstract_inverted_index.certainty). | 229 |
| abstract_inverted_index.combination | 110 |
| abstract_inverted_index.individuals | 238, 260 |
| abstract_inverted_index.significant | 400 |
| abstract_inverted_index.synthesised | 163 |
| abstract_inverted_index.variability | 145, 366 |
| abstract_inverted_index.<0.00001, | 224, 298 |
| abstract_inverted_index.Registration | 481 |
| abstract_inverted_index.improvements | 449 |
| abstract_inverted_index.increasingly | 7 |
| abstract_inverted_index.intervention | 101 |
| abstract_inverted_index.professional | 107 |
| abstract_inverted_index.risk-of-bias | 157 |
| abstract_inverted_index.complications | 421, 478 |
| abstract_inverted_index.comprehensive | 36 |
| abstract_inverted_index.hypoglycaemia | 177, 386, 407, 472 |
| abstract_inverted_index.investigating | 76, 106, 193 |
| abstract_inverted_index.macrovascular | 181, 388, 420, 477 |
| abstract_inverted_index.meta-analysis | 31 |
| abstract_inverted_index.microvascular | 438, 475 |
| abstract_inverted_index.participants, | 190 |
| abstract_inverted_index.complications. | 182, 389, 439 |
| abstract_inverted_index.intermittently | 81 |
| abstract_inverted_index.meta-analysis. | 167 |
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| abstract_inverted_index.self-monitoring | 87 |
| abstract_inverted_index.CRD42023418005). | 490 |
| abstract_inverted_index.glucose-lowering | 115 |
| abstract_inverted_index.non-statistically | 399 |
| abstract_inverted_index.ClinicalTrials.gov | 66 |
| abstract_inverted_index.Conclusions/interpretation | 440 |
| cited_by_percentile_year.max | 100 |
| cited_by_percentile_year.min | 99 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 8 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
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