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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

Maiorino, Maria Ida, Signoriello, Simona, Maio, Antonietta, Chiodini, Paolo, Bellastella, Giuseppe, Scappaticcio, Lorenzo, Longo, Miriam, Giugliano, Dario, Esposito, Katherine·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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Bias in meta-analysis detected by a simple, graphical test
Egger, M., Smith, G. D., Schneider, M., & Minder, C. (1997) · BMJ · doi:10.1136/bmj.315.7109.629 · Cited by 56,722
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000100 · Cited by 28,164
The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long-Term Complications in Insulin-Dependent Diabetes Mellitus
(1993) · New England Journal of Medicine · doi:10.1056/nejm199309303291401 · Cited by 24,667
Cochrane Handbook for Systematic Reviews of Interventions
(2019) · doi:10.1002/9781119536604 · Cited by 14,828
Trim and Fill: A Simple Funnel‐Plot–Based Method of Testing and Adjusting for Publication Bias in Meta‐Analysis
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099
Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range
Wan, X., Wang, W., Liu, J., & Tong, T. (2014) · BMC Medical Research Methodology · doi:10.1186/1471-2288-14-135 · Cited by 11,735
The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration
Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gøtzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00136 · Cited by 10,349
Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study
Stratton, I. M. (2000) · BMJ · doi:10.1136/bmj.321.7258.405 · Cited by 9,059
Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range
Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., Bosi, E., Buckingham, B. A., Cefalu, W. T., Close, K. L., et al. (2019) · Diabetes Care · doi:10.2337/dci19-0028 · Cited by 4,237 · cited 2×
“use in clinical practice to help physicians better define the glycemic status of persons with diabetes (36).”
Background
International consensus on use of continuous glucose monitoring
Danne, T., Nimri, R., Battelino, T., Bergenstal, R. M., Close, K. L., DeVries, J. H., Garg, S., Heinemann, L., Hirsch, I., Amiel, S. A., et al. (2017) · Diabetes Care · doi:10.2337/dc17-1600 · Cited by 2,069
Basics of meta‐analysis: I 2 is not an absolute measure of heterogeneity
Borenstein, M., Higgins, J. P. T., Hedges, L. V., & Rothstein, H. R. (2017) · Research Synthesis Methods · doi:10.1002/jrsm.1230 · Cited by 1,848 · cited 1×
“The proportion of variation in observed effects due to heterogeneity rather than sampling error was evaluated by using I(2) index (15).”
Method
Continuous glucose monitoring and intensive treatment of type 1 diabetes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0805017 · Cited by 1,559
Effect of Continuous Glucose Monitoring on Glycemic Control in Adults With Type 1 Diabetes Using Insulin Injections: The DIAMOND Randomized Clinical Trial
Beck, R. W., Riddlesworth, T., Ruedy, K., Ahmann, A., Bergenstal, R., Haller, S., Kollman, C., Kruger, D., McGill, J. B., Polonsky, W., et al. (2017) · JAMA · doi:10.1001/jama.2016.19975 · Cited by 1,185 · cited 1×
“Insulin delivery was by CSII alone in threetrials (20,31,32), byMDI in five trials (23,24,26,27,30), and by CSII orMDI in seven trials (18,19,21,22,25,28,29).”
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Continuous Glucose Monitoring in Pregnant Women with Type 1 Diabetes (CONCEPTT): a multicentre international randomised controlled trial
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Validation of Time in Range as an Outcome Measure for Diabetes Clinical Trials
Beck, R. W., Bergenstal, R. M., Riddlesworth, T. D., Kollman, C., Li, Z., Brown, A. S., & Close, K. L. (2019) · Diabetes Care · doi:10.2337/dc18-1444 · Cited by 793
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Beck, R. W., Riddlesworth, T. D., Ruedy, K., Ahmann, A., Haller, S., Kruger, D., McGill, J. B., Polonsky, W., Price, D., Aronoff, S., et al. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2855 · Cited by 635
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Yeh, H.-C., Brown, T. T., Maruthur, N., Ranasinghe, P., Berger, Z., Suh, Y. D., Wilson, L. M., Haberl, E. B., Brick, J., Bass, E. B., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-5-201209040-00508 · Cited by 493
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Petrie, J. R., Peters, A. L., Bergenstal, R. M., Holl, R. W., Fleming, G. A., & Heinemann, L. (2017) · Diabetes Care · doi:10.2337/dci17-0043 · Cited by 135
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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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