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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

Chetty, V.T., Almulla, A., Odueyungbo, A., Thabane, L.·2008·Diabetes Research and Clinical Practice
DOI 10.1016/j.diabres.2008.02.014
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Abstract

Background and purpose Continuous glucose monitoring (CGMS) is a relatively new technology that measures interstitial glucose every 5 min for 72 h. The resulting profile provides a more comprehensive measure of glycemic excursions than intermittent self-blood finger-stick glucose monitoring (SBGM) and thus could potentially improve diabetes control. We performed a meta-analysis of randomized controlled trials comparing CGMS and SBGM in Type 1 diabetic patients. Our aim was to determine whether CGMS leads to better hemoglobin A1c (HBA1c) levels, a marker of long-term vascular risk.Methods Randomized controlled trials comparing CGMS and SBGM in Type 1 diabetic patients were identified using both manual and electronic searches of the literature in MEDLINE, EMBASE, PUBMED and Cochrane Central Registry of Controlled Trials from 1996 to March 2007. Relevant studies were independently selected by two reviewers, who also extracted data on study design, quality and effect on HBA1c levels. Data from all trials were pooled using a random effects model.Results Seven studies with a total of 335 patients fulfilled the inclusion criteria. Five studies were confined to the pediatric population (age<18 years). Study duration varied from 12 to 24 weeks. Compared with SBGM, CGMS was associated with a non-significant reduction in HBA1c (0.22%; 95% CI: -0.439% to 0.004%, p=0.055).Conclusions There is insufficient evidence to support the notion that CGMS provides a superior benefit over SBGM in terms of HBA1c reduction. There was some indication of improved detection of asymptomatic nocturnal hypoglycemia in the CGMS group.

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Crossref · 10.1016/j.diabres.2008.02.014

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  • Substantial heterogeneity, inadequate sample sizes, and publication bias were primary reasons for downgrading evidence.

    “primarily due to: ? substantial heterogeneity [24, 38], potentially arising from differences in device brands and intervention durations (1–12 months); ? inadequate sample sizes, with most studies including fewer than 400 participants [15, 25, 30]; ? publication bias, as some systematic reviews were downgraded due to limited literature inclusion or asymmetric funnel plots [27, 30, 31].”

    From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [15]

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Authors
Chetty, V. T., Almulla, A., Odueyungbo, A., & Thabane, L.
Affiliations
  • Hamilton Regional Laboratory Medicine Program (CA)
  • McMaster University (CA)
  • St. Joseph’s Healthcare Hamilton (CA)
Corresponding author
Chetty, V.T.
ORCID
Thabane, L.
Venue
Diabetes Research and Clinical Practice
Publisher
Elsevier BV
Published
2008-07
Volume
81
Issue
1
Pages
79-87
ISSN
0168-8227 (ISSN-L)
DOI
10.1016/j.diabres.2008.02.014
OpenAlex
W2025345162
Cited by
85
References
34
Citations by year
2026: 2 · 2024: 2 · 2023: 1 · 2022: 4 · 2021: 6 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 1 · 2016: 7 · 2015: 3 · 2014: 4 · 2013: 7 · 2012: 8
FWCI
1.48
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Diabetes Research and Clinical Practice (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
continuous glucose monitoring, type 1 diabetes, HbA1c, glycemic control, nocturnal hypoglycemia, glycemic excursions, pediatric diabetes
MeSH terms
Adolescent, Adult, Aged, Blood Glucose, Child, Child, Preschool, Diabetes Mellitus, Type 1, Fingers, Glycated Hemoglobin, Humans, Middle Aged, Quality Assurance, Health Care, Sensitivity and Specificity, Meta-Analysis as Topic, Reproducibility of Results, Observer Variation, Patient Selection, Monitoring, Ambulatory

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