Continuous Glucose Monitoring Versus Self-monitoring of Blood Glucose in Type 2 Diabetes Mellitus: A Systematic Review with Meta-analysis

Every eleventh adult has diabetes, and every third has prediabetes. Over 95% of diabetics are of type 2. It is well established that diabetes doubles the risk of heart disease and stroke apart from increasing the risk of microvascular complications. Hence, strict glycemic control is necessary. Howev...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2019-09, Vol.11 (9), p.e5634
Main Authors: Janapala, Rajesh Naidu, Jayaraj, Joseph S, Fathima, Nida, Kashif, Tooba, Usman, Norina, Dasari, Amulya, Jahan, Nusrat, Sachmechi, Issac
Format: Article
Language:English
Subjects:
Diabetes
Endocrinology/Diabetes/Metabolism
Evidence-based medicine
Glucose
Glucose monitoring
Hemoglobin
Hypoglycemia
Internal Medicine
Medicine
Meta-analysis
Patient satisfaction
Patients
Preventive Medicine
Quality of life
Statistical analysis
Systematic review
Trends
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Summary:Every eleventh adult has diabetes, and every third has prediabetes. Over 95% of diabetics are of type 2. It is well established that diabetes doubles the risk of heart disease and stroke apart from increasing the risk of microvascular complications. Hence, strict glycemic control is necessary. However, it increases the risk of hypoglycemia, especially in patients with longstanding diabetes. Continuous glucose monitors (CGM) use a sensor to continuously measure the glucose levels in the interstitial fluid every 10 seconds and gives out mean values every five minutes. CGMs are emerging tools in the management of type 2 diabetes. The prime objective of this review is to find out if there is enough supporting evidence, suggesting that continuous glucose monitoring is more effective than self-monitoring of blood glucose (SMBG) in type 2 diabetes. We conducted a systematic literature search in Medline (PubMed) looking for any studies addressing our objective. It is observed that there is a varying level of evidence supporting that employing a CGM can reduce glycated hemoglobin (HbA1c), hypoglycemic events, and increase patient satisfaction. However, some studies reported no significant benefits. This systematic review with meta-analysis concludes that the use of CGM in type 2 diabetes mellitus (T2DM) is beneficial, as it significantly reduces HbA1c compared to the usual method of SMBG. The pooled mean difference in HbA1c was -0.25 (-0.45, -0.06) and statistically significant (at = 0.01) when comparing CGM to SMBG.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.5634