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Abstract:
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Introduction: Continuous glucose monitoring (CGM) has shown favorable outcomes in patients
with T2D who are on insulin therapy. However, the efficacy of CGM in managing glucose levels
in non-insulin-treated people with T2D remains controversial.
Methods: PubMed, Cochrane, and Embase were searched for randomized controlled trials
(RCTs) comparing CGM to self-monitoring of blood glucose (SMBG) in people with T2D not
using insulin. We computed weighted mean differences (WMDs) and standard mean differences
(SMD) for continuous outcomes, with 95% confidence intervals (95%CIs). Heterogeneity was
assessed using I2 statistics. Statistical analyses were performed using R version 4.2.3.
Results: We included six RCTs comprising 407 non-insulin-treated people with T2D of whom
228 were randomized to CGM. Diabetes duration ranged from 5.4 to 13.9 years. The mean age
was 57.9 years and the mean body mass index was 30.8 kg/m2. Four trials used real-time CGM
(rt-CGM) and 2 intermittent scanning CGM (is-CGM). Compared with SMBG, CGM
significantly reduced the glycated hemoglobin (HbA1c) level (WMD -0.31%; 95%CI -0.42,-0.21;
I2=0%), glucose level (WMD -11.16 mg/dl; 95%CI -19.94,-2.39; I2=0%), time in hypoglycemia
level 2 (WMD -0.28%; 95%CI -0.52,-0.03; I2=91%), glucose time >180 mg/dl (WMD -7.75%;
95%CI -12.04,-3.45; I2=0%) and the standard deviation of glucose variation (WMD -4.00 mg/dl;
95%CI -6.86,-1.14; I2=0%). CGM also increased time in range (WMD 8.63%; 95%CI 4.54,12.71;
I2=0%) and treatment satisfaction (SMD 0.79; 95%CI 0.54,1.05; I
2=0%). Conclusion: In this meta-analysis, rt-CGM and is-CGM were associated with improvement in
glycemic control in people with T2D not using insulin when compared to SMBG. |
