Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis

IF 2.7

Metabolism open Pub Date : 2025-07-29 DOI:10.1016/j.metop.2025.100382

Salya F. Alfadli , Yazeed S. Alotaibi , Maha J. Aqdi , Latifah A. Almozan , Zahra B. Alzubaidi , Hammad A. Altemani , Shaden D. Almutairi , Hussain A. Alabdullah , Alaa Ahmed Almehmadi , Abdulrahman L. Alanzi , Ahmed Y. Azzam

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Abstract

Introduction

Continuous glucose monitoring (CGM) technologies have been advancing rapidly, but evidence on their comparative effectiveness stills limited to date yet. We conducted a systematic review and meta-analysis to evaluate and investigate the impact of CGM systems on glycemic control in adults with type 1 diabetes.

Methods

We searched electronic literature databases from inception through April 30, 2025, for comparative studies investigating CGM systems with standard monitoring or different CGM technologies in adults with type 1 diabetes. Primary outcomes included HbA1c reduction, time in range (TIR), and hypoglycemia reduction. We performed random-effects meta-analyses, network meta-analysis, and subgroup analyses by baseline HbA1c and intervention duration. Evidence quality was assessed using GRADE methodology.

Results

Twenty-seven studies with total of 2975 participants were included. CGM significantly reduced HbA1c compared to standard monitoring (mean difference: 0.38 %, 95 % CI: 0.49 to −0.27 %). TIR increased by 7.9 % (95 % CI: 5.8–10.0 %), representing 114 additional minutes daily in best range. Real-time CGM showed advantages over intermittently scanned CGM for TIR (+5.63 %, P-value<0.001) and hypoglycemia reduction (−1.28 %, P-value<0.001). Automated closed-loop systems achieved the highest ranking in network meta-analysis (SUCRA = 0.92). Benefits were greater among patients with higher baseline HbA1c (>8.5 %: 0.68 % reduction in HbA1c vs. <7.5 %: 0.24 % reduction in HbA1c, P-value = 0.009).

Conclusions

CGM technologies significantly improve glycemic control in adults with type 1 diabetes, with greater benefits for those with higher baseline HbA1c. Advanced systems demonstrate progressively greater improvements, with automated closed-loop systems showing the strongest evidence of effectiveness. These findings support broader implementation of CGM technologies, with selection tailored to individual patient needs.

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连续血糖监测系统对成人1型糖尿病患者血糖控制的有效性：一项系统综述和荟萃分析

连续血糖监测（CGM）技术发展迅速，但迄今为止，其相对有效性的证据仍然有限。我们进行了一项系统回顾和荟萃分析，以评估和研究CGM系统对成人1型糖尿病患者血糖控制的影响。方法：我们检索了从成立到2025年4月30日的电子文献数据库，对标准监测或不同CGM技术的成人1型糖尿病患者的CGM系统进行了比较研究。主要结局包括HbA1c降低、范围时间（TIR）和低血糖降低。我们根据基线HbA1c和干预持续时间进行了随机效应荟萃分析、网络荟萃分析和亚组分析。采用GRADE方法评估证据质量。结果纳入27项研究，共2975名受试者。与标准监测相比，CGM显著降低了HbA1c（平均差异：0.38%,95% CI: 0.49至- 0.27%）。TIR增加了7.9% (95% CI: 5.8 - 10.0%)，在最佳范围内每天增加114分钟。实时CGM在TIR （+ 5.63%， p值<；0.001）和低血糖降低（- 1.28%，p值<；0.001）方面优于间歇扫描CGM。自动化闭环系统在网络meta分析中排名最高（SUCRA = 0.92）。基线HbA1c较高的患者获益更大（HbA1c降低>； 8.5%: 0.68% vs HbA1c降低<； 7.5%: 0.24%， p值= 0.009）。结论：scgm技术可显著改善成人1型糖尿病患者的血糖控制，对基线HbA1c较高的患者疗效更大。先进的系统显示出越来越大的改进，自动化闭环系统显示出最有力的有效性证据。这些发现支持更广泛地实施CGM技术，并根据患者的个体需求进行选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Metabolism open Agricultural and Biological Sciences (General), Endocrinology, Endocrinology, Diabetes and Metabolism

自引率

0.00%

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审稿时长

40 days