Continuous glucose monitoring may be effective and safe in type 1 diabetes compared with SMBG

CGM monitor

Clinical question

In patients with type 1 diabetes, does Continuous glucose monitoring (CGM) compared with self-management of blood glucose (SMBG) lead to an improvement in glycaemic control or a reduction in hypoglycemia?

Methods

Systematic review of randomised trials.  14 trials were found, comprising 1,268 participants.

Bottom line

Real-time CGM was associated with a 0.26% (95% CI: -0.34% to -0.19%) greater mean reduction in HbA1c  compared with SMBG.  CGM patients had fewer hypoglycemic episodes.

Appraisal hints

Users of this research are advised to consider:

  • Whether the reviewers identified all of the relevant studies
  • Whether they carried out blind, independent evaluation of study quality and extraction of data
  • Could the individual studies have been affected by significant bias?
  • Whether the individual studies were sufficiently similar to merit combining into one overall estimate of benefit
  • Was the observed benefit clinically significant and achievable in real life?

Reference

Wojciechowski P, Ryś P, Lipowska A, Gawęska M, Małecki MT. Efficacy and safety comparison of continuous glucose monitoring and self-monitoring of blood glucose in type 1 diabetes: systematic review and meta-analysis. Pol Arch Med Wewn. 2011 Oct;121(10):333-44.

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Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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