Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials
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Aims: We aimed to conduct a systematic review and meta‐analysis of randomised controlled clinical trials (RCTs) assessing separately and together the effect of the three distinct categories of continuous glucose monitoring (CGM) systems (adjunctive, non‐adjunctive and intermittently‐scanned CGM [isCGM]), compared with traditional capillary glucose monitoring, on HbA1c and CGM metrics. Methods: PubMed, Web of Science, Scopus and Cochrane Central register of clinical trials were searched. Inclusion criteria were as follows: randomised controlled trials; participants with type 1 diabetes of any age and insulin regimen; investigating CGM and isCGM compared with traditional capillary glucose monitoring; and reporting glycaemic outcomes of HbA1c and/or time‐in‐range (TIR). Glycaemic outcomes were extracted post‐intervention and expressed as mean differences and 95%CIs between treatment and comparator groups. Results were pooled using a random‐effects meta‐analysis. Risk of bias was assessed using the Cochrane Rob2 tool. Results: This systematic review was conducted between January and April 2021; it included 22 RCTs (15 adjunctive, 5 non‐adjunctive, and 2 isCGM)). The overall analysis of the pooled three categories showed a statistically significant absolute improvement in HbA1c percentage points (mean difference (95% CI): −0.22% [−0.31 to −0.14], I2 = 79%) for intervention compared with comparator and was strongest for adjunctive CGM (−0.26% [−0.36, −0.16]). Overall TIR (absolute change) increased by 5.4% (3.5 to 7.2), I2 = 71% for CGM intervention compared with comparator and was strongest with non‐adjunctive CGM (6.0% [2.3, 9.7]). Conclusions: For individuals with T1D, use of CGM was beneficial for impacting glycaemic outcomes including HbA1c, TIR and time‐below‐range (TBR). Glycaemic improvement appeared greater for TIR for newer non‐adjunctive CGM technology.
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Integration of continuous glucose monitoring (CGM) into the treatment plan soon after diagnosis improves glycemic outcomes, decreases hypoglycemic events, and improves quality of life for individuals with type 1 diabetes.
“Integration of continuous glucose monitoring (CGM) into the treatment plan soon after diagnosis improves glycemic outcomes, decreases hypoglycemic events, and improves quality of life for individuals with type 1 diabetes (18-23).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [19]
The Abstract Conclusions report improved glycaemic outcomes, including HbA1c, time in range, and time below range; the Discussion links CGM to minimising hypoglycaemia. The paper does not establish that starting CGM soon after diagnosis produces these benefits or report an improvement in quality of life. The supplied passages have no page numbers. (LLM, conf=0.88)
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- Authors
- Elbalshy, M., Haszard, J., Smith, H., Kuroko, S., Galland, B., Oliver, N., Shah, V., de Bock, M. I., & Wheeler, B. J.
- Affiliations
- University of Otago (NZ)
- Imperial College London (GB)
- University of Colorado Anschutz (US)
- Department of Paediatrics University of Otago Christchurch New Zealand
- Southern District Health Board (NZ)
- Corresponding author
- Wheeler, Benjamin J.
- ORCID
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2022-04-25
- Volume
- 39
- Issue
- 8
- Pages
- e14854-e14854
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- PMC
- PMC9542260
- OpenAlex
- W4224293604
- Cited by
- 104
- References
- 56
- Citations by year
- 2026: 17 · 2025: 24 · 2024: 22 · 2023: 32 · 2022: 8
- FWCI
- 3.06
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetic Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Dexcom
- 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, glycemic control, HbA1c, time in range, time below range, flash glucose monitoring, insulin therapy
- MeSH terms
- Glycemic Control, Blood Glucose, Diabetes Mellitus, Type 1, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Technology, Blood Glucose Self-Monitoring, Randomized Controlled Trials as Topic
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