Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials

Maiorino, Maria Ida; Signoriello, Simona; Maio, Antonietta; Chiodini, Paolo; Bellastella, Giuseppe; Scappaticcio, Lorenzo; Longo, Miriam; Giugliano, Dario; Esposito, Katherine

doi:10.2337/dc19-1459

Cited by 364Diabetes Management and ResearchDiabetes Treatment and ManagementDiabetes Management and Education

Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials

Maiorino, Maria Ida, Signoriello, Simona, Maio, Antonietta, Chiodini, Paolo, Bellastella, Giuseppe, Scappaticcio, Lorenzo, Longo, Miriam, Giugliano, Dario +1 more·2020·Diabetes Care

DOI 10.2337/dc19-1459

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Abstract

Background Continuous glucose monitoring (CGM) provides important information to aid in achieving glycemic targets in people with diabetes. Purpose We performed a meta-analysis of randomized controlled trials (RCTs) comparing CGM with usual care for parameters of glycemic control in both type 1 and type 2 diabetes. Data sources Many electronic databases were searched for articles published from inception until 30 June 2019. Study selection We selected RCTs that assessed both changes in HbA 1c and time in target range (TIR), together with time below range (TBR), time above range (TAR), and glucose variability expressed as coefficient of variation (CV). Data extraction Data were extracted from each trial by two investigators. Data synthesis All results were analyzed by a random effects model to calculate the weighted mean difference (WMD) with the 95% CI. We identified 15 RCTs, lasting 12-36 weeks and involving 2,461 patients. Compared with the usual care (overall data), CGM was associated with modest reduction in HbA 1c (WMD -0.17%, 95% CI -0.29 to -0.06, I 2 = 96.2%), increase in TIR (WMD 70.74 min, 95% CI 46.73-94.76, I 2 = 66.3%), and lower TAR, TBR, and CV, with heterogeneity between studies. The increase in TIR was significant and robust independently of diabetes type, method of insulin delivery, and reason for CGM use. In preplanned subgroup analyses, real-time CGM led to the higher improvement in mean HbA 1c (WMD -0.23%, 95% CI -0.36 to -0.10, P P Limitations Heterogene…

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Glycemic management of T1DM has increasingly focused beyond HbA1c alone to include metrics such as TIR, hypoglycemia exposure, and glycemic variability.
“The glycemic management of T1DM has increasingly focused beyond HbA1c alone to include metrics such as TIR, hypoglycemia exposure, and glycemic variability, which reflect day-to-day glucose control and its impact on patients' lives.”
From Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis (2025) · cites this paper as [42]
Similar glycaemic improvements are found in trials comparing intermittently scanned (flash) monitoring with capillary blood glucose monitoring.
“Similar results have been found in trials comparing intermittently scanned (flash) monitoring with capillary blood glucose monitoring.18,19”
From Blood glucose monitoring devices: current considerations (2023) · cites this paper as [18]
In pivotal trials, continuous glucose monitoring typically decreased glycated haemoglobin by 0.4-0.6%, increased time in target range (3.9-10 mmol/L) by 60-100 minutes/day, and decreased time below target range by 10-45 minutes/day.
“In pivotal trials, glycated haemoglobin concentrations typically decreased by 0.4–0.6%, the time in target range (3.9–10 mmol/L) increased by 60–100 minutes/day, and the time below target range decreased by 10–45 minutes/day.18”
From Blood glucose monitoring devices: current considerations (2023) · cites this paper as [18]

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Feasibility of intraoperative continuous glucose monitoring: An observational study in general surgery patients
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Making Diabetes Care Fit—Are We Making Progress?
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Effectiveness of Non-Contact Dietary Coaching in Adults with Diabetes or Prediabetes Using a Continuous Glucose Monitoring Device: A Randomized Controlled Trial
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Insertable Biosensors: Combining Implanted Sensing Materials with Wearable Monitors
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The Performance of Continuous Glucose Monitoring During the Intraoperative Period: A Scoping Review
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Ranolazine Improves Glycemic Variability and Endothelial Function in Patients with Diabetes and Chronic Coronary Syndromes: Results from an Experimental Study
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Partnering for Better Health: Using Continuous Glucose Monitoring and Clinical Pharmacist Collaboration to Improve Glycemic Control in Underserved Patients With Type 2 Diabetes
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Insulinpumpe, kontinuierliche und kapilläre Glukosemessung bei Kindern, Jugendlichen und Erwachsenen mit Diabetes mellitus: Daten des DPV-Registers zwischen 1995 und 2019
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The therapeutic efficacy of continuous glucose monitoring in diabetes: an updated meta-analysis with meta-regression
Maiorino, M. I., Martino, N. D., Angelino, S., Maio, A., Caruso, P., Petrizzo, M., Scappaticcio, L., Longo, M., Forestiere, D., Porcellini, C., et al. (2025) · Endocrine · doi:10.1007/s12020-025-04405-6 · Cited by 2 · see citing works
Self-citation
Effectiveness of Continuous Glucose Monitoring on Metrics of Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Uhl, S., Choure, A., Rouse, B., Loblack, A., & Reaven, P. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgad652 · Cited by 76 · see citing works
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
Elbalshy, M., Haszard, J., Smith, H., Kuroko, S., Galland, B., Oliver, N., Shah, V., de Bock, M. I., & Wheeler, B. J. (2022) · Diabetic Medicine · doi:10.1111/dme.14854 · Cited by 104 · see citing works
Continuous glucose monitoring in adults with type 2 diabetes: a systematic review and meta-analysis
Jancev, M., Vissers, T. A. C. M., Visseren, F. L. J., van Bon, A. C., Serné, E. H., DeVries, J. H., de Valk, H. W., & van Sloten, T. T. (2024) · Diabetologia · doi:10.1007/s00125-024-06107-6 · Cited by 191 · see citing works
Continuous Glucose Monitoring in Type 1 Diabetes, Type 2 Diabetes, and Diabetes During Pregnancy: A Systematic Review with Meta-Analysis of Randomized Controlled Trials
Rizos, E. C., Markozannes, G., Charitakis, N., Filis, P., Stoimeni, A. E., Nørgaard, K., Ntzani, E. E., & Tsilidis, K. K. (2025) · Diabetes Technology & Therapeutics · doi:10.1089/dia.2024.0599 · Cited by 18 · see citing works

Authors: Maiorino, M. I., Signoriello, S., Maio, A., Chiodini, P., Bellastella, G., Scappaticcio, L., Longo, M., Giugliano, D., & Esposito, K.
Affiliations: University of Campania "Luigi Vanvitelli" (IT)
Corresponding author: Maiorino, Maria Ida
ORCID: Maiorino, Maria Ida
Signoriello, Simona
Maio, Antonietta
Chiodini, Paolo
Bellastella, Giuseppe
Scappaticcio, Lorenzo
Longo, Miriam
Giugliano, Dario
Esposito, Katherine
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2020-04-13
Volume: 43
Issue: 5
Pages: 1146-1156
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/dc19-1459
OpenAlex: W3017384252
Cited by: 364
References: 45
Citations by year: 2026: 45 · 2025: 76 · 2024: 75 · 2023: 59 · 2022: 53 · 2021: 37 · 2020: 19
FWCI: 6.45
Type: journal article
Language: en
Open access: closed
Licence: www.diabetesjournals.org/content/license (vor, 7 d)
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: continuous glucose monitoring, glycemic control, HbA1c, time in range, time below range, time above range, glycemic variability, coefficient of variation, type 1 diabetes, type 2 diabetes, sensor-augmented pump, flash glucose monitoring, real-time CGM, usual care comparison, insulin delivery method, hypoglycemia, hyperglycemia
MeSH terms: Glycemic Control, Blood Glucose, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Female, Humans, Insulin, Male, Time Factors, Blood Glucose Self-Monitoring, Randomized Controlled Trials as Topic, Databases, Factual, Outcome Assessment, Health Care, Benchmarking

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Effects of Continuous Glucose Monitoring on Metrics of Glycemic Control in Diabetes: A Systematic Review With Meta-analysis of Randomized Controlled Trials

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