Comparing the glycaemic outcomes between real‐time continuous glucose monitoring ( rt‐CGM ) and intermittently scanned continuous glucose monitoring ( isCGM ) among adults and children with type 1 diabetes: A systematic review and meta‐analysis of randomized controlled trials
Open accessAbstract
Aim: To conduct a systematic review and meta‐analysis of randomized controlled trials (RCTs) comparing the effectiveness of real‐time continuous glucose monitoring (rtCGM) versus intermittently scanned continuous glucose monitoring (isCGM) on key glycaemic metrics (co‐primary outcomes HbA1c and time‐in‐range [TIR] 70–180 mg/dL, 3.9–10.0 mmol/L) among people with type 1 diabetes (T1D). Methods: Medline, PubMed, Scopus, Web of Science and Cochrane Central Register of clinical trials were searched. Inclusion criteria were RCTs; T1D populations of any age and insulin regimen; comparing any type of rtCGM with isCGM (only the first generation had been compared to date); and reporting the glycaemic outcomes. Glycaemic outcomes were extracted post‐intervention and expressed as mean differences and 95% CIs between the two comparators. Results were pooled using a random‐effect meta‐analysis. The risk of bias was assessed using the Cochrane RoB2 tool. The quality of evidence was assessed by the GRADE approach. Results: Five RCTs met the inclusion criteria (4 parallel and 1 crossover design; 4 with CGM use <8 weeks), involving 446 participants (354 adults; 92 children and adolescents). Overall, meta‐analysis showed rtCGM compared to isCGM improved absolute TIR by +7.0% (95% CI: 5.8%–8.3%, I 2 = 0%, p < 0.01) accompanied by a favorable effect on time‐below‐range <70 mg/dL (3.9 mmol/L) – 1.7% (95%CI: −3.0% to −0.4%; p = 0.03). No differences were seen regarding HbA1c. Conclusions: This meta‐analysis highlights that for people with T1D, rtCGM confers benefits over isCGM primarily related to increased TIR, with improvements in hypo‐ and hyperglycaemia.
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RT-CGM outperforms isCGM in reducing HbA1c and minimizing hypoglycemic episodes.
“as RT‐CGM outperforms isCGM in reducing HbA1c and minimizing hypoglycemic episodes [30]”
From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [30]
The Results summary (section 1) reports less time below the hypoglycaemia threshold with rt-CGM than with isCGM, but no difference in HbA1c. The Primary outcomes section (3.3) confirms that the pooled HbA1c difference was not statistically significant. The hypoglycaemia measure was time below range, not a count of episodes. (LLM, conf=0.90)
Experimental — accuracy not yet measuredSome studies failed to justify sample size calculations, undermining result credibility.
“Some studies failed to justify sample size calculations, further undermining result credibility [30, 31].”
From Effectiveness of Wearable Devices for Diabetes Management: An Overview of Systematic Reviews and Meta‐Analyses (2026) · cites this paper as [30]
The Discussion (page unavailable) says the small sample size of the available evidence may prevent reliable conclusions for some comparisons. It does not say that any included studies failed to justify their sample size calculations; searches for that point found no supporting passage. (LLM, conf=0.82)
Experimental — accuracy not yet measured
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Cited by
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- Authors
- Zhou, Y., Sardana, D., Kuroko, S., Haszard, J. J., de Block, M. I., Weng, J., Jefferies, C., & Wheeler, B. J.
- Affiliations
- University of Science and Technology of China (CN)
- OU Health (US)
- University of Otago (NZ)
- Department of Paediatrics University of Otago Christchurch New Zealand
- University of Auckland (NZ)
- Health New Zealand (NZ)
- Corresponding author
- Wheeler, Benjamin John
- ORCID
- Venue
- Diabetic Medicine
- Publisher
- Wiley
- Published
- 2024-01-10
- Volume
- 41
- Issue
- 3
- Pages
- e15280-e15280
- ISSN
- 0742-3071 (ISSN-L)
- 1464-5491
- OpenAlex
- W4390696862
- Cited by
- 25
- References
- 27
- Citations by year
- 2026: 9 · 2025: 9 · 2024: 7
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetic Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, cc-by-nc-nd)
- Funders
- University of Otago
- 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
- type 1 diabetes, real-time continuous glucose monitoring, intermittently scanned continuous glucose monitoring, glycemic control, HbA1c, time in range, time below range, hypoglycemia, hyperglycemia, children and adolescents, adults
- MeSH terms
- Continuous Glucose Monitoring, Adolescent, Adult, Blood Glucose, Child, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Blood Glucose Self-Monitoring, Randomized Controlled Trials as Topic
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