Continuous glucose monitoring technologies and their impact on diabetes outcomes

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Created On: 24/07/2025

Continuous glucose monitoring (CGM), including real-time CGM (RT-CGM) and retrospective (professional) CGM (non-RT-CGM), is an innovative method for tracking glucose levels and their fluctuations.

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Key take away

Compared to BGM, RT-CGM effectively lowers HbA1c and abnormal glucose fluctuations while increasing time spent within target glucose levels in T1D and T2D.

Background

Continuous glucose monitoring (CGM), including real-time CGM (RT-CGM) and retrospective (professional) CGM (non-RT-CGM), is an innovative method for tracking glucose levels and their fluctuations.

This meta-analysis of randomized controlled trials (RCTs) was carried out to evaluate the impact of RT-CGM and non-RT-CGM on individuals with type 1 diabetes (T1D), type 2 diabetes (T2D), and diabetes during pregnancy, compared to traditional self blood glucose monitoring (BGM).

Method

A comprehensive search was executed across PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. The main outcomes analyzed were the weighted mean change differences (WMCDs) from baseline in glycated hemoglobin (HbA1c), as well as changes in time in range (TIR%), time below range (TBR%), and time above range (TAR%).

Result

Data from 64 RCTs were included. The key findings were:

RT-CGM in T1D: Compared to BGM, RT-CGM showed greater reductions in HbA1c (WMCD −0.24; I² = 71%), significant decreases in time spent below 70 mg/dL (WMCD −2.41; I² = 96%) and below 54 mg/dL (WMCD −1.18; I² = 97%), reductions in time above 180 mg/dL (WMCD −2.99; I² = 92%) and above 250 mg/dL (WMCD −3.99; I² = 92%), alongside an increase in time within the 70–180 mg/dL range (WMCD 5.57; I² = 84%).
RT-CGM in T2D: RT-CGM outperformed BGM in reducing HbA1c (WMCD −0.40; I² = 52%), lowering time above 180 mg/dL (WMCD −6.32; I² = 84%) and above 250 mg/dL (WMCD −5.73; I² = 89%), as well as increasing time in the 70–180 mg/dL range (WMCD 5.46; I² = 69%).
RT-CGM in diabetes during pregnancy: RT-CGM showed superiority over BGM by increasing time in range 63–140 mg/dL (WMCD 17.77; I² = 92%), but no vital improvements were noted in HbA1c, time below 63 mg/dL, time above 140 mg/dL, or most maternal and neonatal outcomes.
Non-RT CGM: In T2D, the use of non-RT CGM led to a prominent reduction in HbA1c compared to BGM (WMCD −0.35; I² = 19%).

Conclusion

For those with T1D and T2D, RT-CGM effectively lowered HbA1c levels and increased the time glucose levels remained within the target range (70–180 mg/dL), while reducing time spent in hypoglycemia (T1D) and hyperglycemia (both T1D and T2D).

Source:

Diabetes Technology & Therapeutics

Link:

https://www.liebertpub.com/doi/abs/10.1089/dia.2024.0599

Article:

Continuous Glucose Monitoring in Type 1 Diabetes, Type 2 Diabetes, and Diabetes During Pregnancy: A Systematic Review with Meta-Analysis of Randomized Controlled Trials