Does Continuous Glucose Monitoring Improve Glycemic Control and Quality of Life Among Adults With Type 2 Diabetes in Primary Care Settings? A Systematic Review and Meta-Analysis.

Abstract

Purpose: The purpose of this systematic review and meta-analysis was to evaluate the impact of continuous glucose monitoring (CGM) on glycemic control and quality of life (QoL) among adults with type 2 diabetes (T2DM) managed within primary care settings.

Methods: Following PRISMA 2020 guidelines, 4 databases were comprehensively searched for randomized controlled trials (RCTs) published through July 9, 2025. Eligible trials reported on A1C, QoL, diabetes distress, and device satisfaction. Shorter term (6-8 months) and longer term (12-14 months) A1C outcomes were synthesized using random effects meta-analysis models.

Results: Of 739 records, 4 multisite RCTs (6 reports) met inclusion criteria and represent data from 566 adults with T2DM in primary care settings. Two trials utilized real time CGM, while others employed retrospective or intermittently scanned CGM. Participants attended primary care visits during the trial, receiving diabetes management and medication changes as required. The CGM intervention significantly improved glycemic control with pooled A1C reduction of -0.46% at 6 to 8 months and -0.33% at 12 to 14 months and device satisfaction with no differences in QoL.

Conclusion: These results demonstrate that CGM significantly improves glycemic control with no change in QoL among adults with T2DM in primary care and suggest that CGM utilization within this setting offers distinct advantages in patient engagement and diabetes management, particularly when integrated through a multidisciplinary team approach. Future research should prioritize populations currently ineligible for CGM coverage, such as non-insulin-using patients and underserved groups, while also investigating the impact of updated sensors' accuracy on clinical outcomes.