Diabetes Research and Clinical Practice
Volume 81, Issue 1 , Pages 79-87, July 2008

The effect of continuous subcutaneous glucose monitoring (CGMS) versus intermittent whole blood finger-stick glucose monitoring (SBGM) on hemoglobin A1c (HBA1c) levels in Type I diabetic patients: A systematic review

  • V.T. Chetty

      Affiliations

    • HRLMP McMaster University, L402-3 Core Lab, St Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, ON L8N 4A6, Canada
    • Corresponding Author InformationCorresponding author.
    • ,
  • A. Almulla

      Affiliations

    • Department of Neuromuscular Unit, McMaster University, Hamilton, ON, Canada
    • ,
  • A. Odueyungbo

      Affiliations

    • Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
    • Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
    • ,
  • L. Thabane

      Affiliations

    • Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
    • Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada

Received 13 November 2007; accepted 26 February 2008. published online 17 April 2008.

Abstract 

Background and purpose

Continuous glucose monitoring (CGMS) is a relatively new technology that measures interstitial glucose every 5min for 72h. The resulting profile provides a more comprehensive measure of glycemic excursions than intermittent self-blood finger-stick glucose monitoring (SBGM) and thus could potentially improve diabetes control. We performed a meta-analysis of randomized controlled trials comparing CGMS and SBGM in Type 1 diabetic patients. Our aim was to determine whether CGMS leads to better hemoglobin A1c (HBA1c) levels, a marker of long-term vascular risk.

Methods

Randomized controlled trials comparing CGMS and SBGM in Type 1 diabetic patients were identified using both manual and electronic searches of the literature in MEDLINE, EMBASE, PUBMED and Cochrane Central Registry of Controlled Trials from 1996 to March 2007. Relevant studies were independently selected by two reviewers, who also extracted data on study design, quality and effect on HBA1c levels. Data from all trials were pooled using a random effects model.

Results

Seven studies with a total of 335 patients fulfilled the inclusion criteria. Five studies were confined to the pediatric population (age<18 years). Study duration varied from 12 to 24 weeks. Compared with SBGM, CGMS was associated with a non-significant reduction in HBA1c (0.22%; 95% CI: −0.439% to 0.004%, p=0.055).

Conclusions

There is insufficient evidence to support the notion that CGMS provides a superior benefit over SBGM in terms of HBA1c reduction. There was some indication of improved detection of asymptomatic nocturnal hypoglycemia in the CGMS group.

Keywords: Systematic review, Meta-analysis, CGMS, SBGM, Interstitial glucose

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PII: S0168-8227(08)00097-1

doi:10.1016/j.diabres.2008.02.014

Diabetes Research and Clinical Practice
Volume 81, Issue 1 , Pages 79-87, July 2008

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