Janapala Rajesh Naidu, Jayaraj Joseph S, Fathima Nida, Kashif Tooba, Usman Norina, Dasari Amulya, Jahan Nusrat, Sachmechi Issac
Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, New York, USA.
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2019 Sep 12;11(9):e5634. doi: 10.7759/cureus.5634.
Every eleventh adult has diabetes, and every third has prediabetes. Over 95% of diabetics are of type 2. It is well established that diabetes doubles the risk of heart disease and stroke apart from increasing the risk of microvascular complications. Hence, strict glycemic control is necessary. However, it increases the risk of hypoglycemia, especially in patients with longstanding diabetes. Continuous glucose monitors (CGM) use a sensor to continuously measure the glucose levels in the interstitial fluid every 10 seconds and gives out mean values every five minutes. CGMs are emerging tools in the management of type 2 diabetes. The prime objective of this review is to find out if there is enough supporting evidence, suggesting that continuous glucose monitoring is more effective than self-monitoring of blood glucose (SMBG) in type 2 diabetes. We conducted a systematic literature search in Medline (PubMed) looking for any studies addressing our objective. It is observed that there is a varying level of evidence supporting that employing a CGM can reduce glycated hemoglobin (HbA1c), hypoglycemic events, and increase patient satisfaction. However, some studies reported no significant benefits. This systematic review with meta-analysis concludes that the use of CGM in type 2 diabetes mellitus (T2DM) is beneficial, as it significantly reduces HbA1c compared to the usual method of SMBG. The pooled mean difference in HbA1c was -0.25 (-0.45, -0.06) and statistically significant (at = 0.01) when comparing CGM to SMBG.
每十一个成年人中就有一个患有糖尿病，每三个成年人中就有一个患有糖尿病前期。超过95%的糖尿病患者为2型糖尿病。众所周知，糖尿病除了会增加微血管并发症的风险外，还会使心脏病和中风的风险加倍。因此，严格控制血糖是必要的。然而，这会增加低血糖的风险，尤其是在长期糖尿病患者中。连续血糖监测仪（CGM）使用传感器每10秒连续测量一次组织间液中的葡萄糖水平，并每五分钟给出一个平均值。CGM是2型糖尿病管理中正在兴起的工具。本综述的主要目的是找出是否有足够的支持证据，表明在2型糖尿病中连续血糖监测比自我血糖监测（SMBG）更有效。我们在Medline（PubMed）中进行了系统的文献检索，以寻找任何针对我们目标的研究。据观察，有不同程度的证据支持使用CGM可以降低糖化血红蛋白（HbA1c）、低血糖事件，并提高患者满意度。然而，一些研究报告称没有显著益处。这项带有荟萃分析的系统综述得出结论，在2型糖尿病（T2DM）中使用CGM是有益的，因为与常规的SMBG方法相比，它能显著降低HbA1c。将CGM与SMBG进行比较时，HbA1c的合并平均差异为-0.25（-0.45，-0.06），且具有统计学显著性（在α = 0.01时）。
