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

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

{"title":"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","authors":"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","doi":"10.1016/j.metop.2025.100382","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":94141,"journal":{"name":"Metabolism open","volume":"27 ","pages":"Article 100382"},"PeriodicalIF":2.7000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effectiveness of continuous glucose monitoring systems on glycemic control in adults with type 1 diabetes: A systematic review and meta-analysis\",\"authors\":\"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\",\"doi\":\"10.1016/j.metop.2025.100382\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>\",\"PeriodicalId\":94141,\"journal\":{\"name\":\"Metabolism open\",\"volume\":\"27 \",\"pages\":\"Article 100382\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Metabolism open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2589936825000386\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Metabolism open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2589936825000386","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}

引用次数: 0

摘要

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。

查看原文本刊更多论文

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

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.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

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

自引率

0.00%

发文量

审稿时长

40 days