Diabetes Management with Wearable Continuous Glucose Monitoring Trackers: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials

Patankar  Chinmayee Nilesh; Jahnavi Hegde; Ramesh Athe

doi:10.18502/jbe.v11i1.19314

Patankar Chinmayee Nilesh Department of Computer Science Engineering, Indian Institute of Information Technology Dharwad, Karnataka, India.
Jahnavi Hegde Department of Computer Science Engineering, Indian Institute of Information Technology Dharwad, Karnataka, India.
Ramesh Athe Department of Data Science and Artificial Intelligence, Indian Institute of Information Technology Dharwad, Karnataka, India.

DOI: https://doi.org/10.18502/jbe.v11i1.19314

Keywords: Diabetes management; Continuous glucose monitoring (CGM); Glycemic control; HbA1c; Systematic review; Meta-analysis

Abstract

Introduction: Continuous glucose monitoring (CGM) has become an essential tool in diabetes management as it provides real-time information on blood glucose levels. Present study summarizes current evidence on the clinical outcomes, glycemic control, and patient-reported outcomes of CGM compared to non-CGM strategies among the included studies with diabetes.

Methods: The systematic review was performed following the PRISMA guidelines. PubMed, Google Scholar, JAMA Network, and SpringerLink, etc. were searched for relevant research published after 2010. Included research assessed the use of CGM with non-CGM treatments, such as traditional therapy or self-monitoring of blood glucose (SMBG) for diabetics. The study's design, participant characteristics, intervention specifics, glycemic outcomes (i.e. HbA1c and duration in range), and quality of life were all included in the extracted data.

Results: Twelve studies (1916 subjects) based on randomized controlled trials and satisfied the inclusion criteria. Findings show that using a CGM is linked to notable improvements in glycemic control, as evidenced by falls in HbA1c readings when compared to non-CGM approaches. The studies had adequate heterogeneity: I² = 32%, Chi² = 16.08, and Tau² = 0.00. An impact was found in the overall effect using a random effects model, with weighted mean difference (WMD) = 0.43; CI: 0.34-0.52 (p<0.001). To evaluate the cause of heterogeneity and publication bias, meta-regression and Egger's regression were used.

Conclusion: This study highlights the potential of CGM devices to enhance diabetes management by improving glycemic control and patient outcomes. Despite several obstacles, CGM shows promise as a substitute for conventional diabetes treatment approaches. Future studies should address these issues and assess the long-term advantages of using a CGM in more detail. This study is registered in PROSPERO (Registration ID: CRD42024518635).