Real-Time Glucose Monitoring Improves Blood Sugar Control in Type 1 and Type 2 Diabetes, Study Finds

The findings, published in Diabetes Technology & Therapeutics, suggest that RT-CGM significantly improves glycemic control by lowering HbA1c levels, increasing time spent in the target glucose range, and reducing episodes of hypoglycemia and hyperglycemia in individuals with diabetes.

"In Type 1 and Type 2 diabetes, RT-CGM lowered HbA1c, improved time spent within the target glucose range (70–180 mg/dL), and reduced episodes of hypoglycemia in T1D and hyperglycemia in both T1D and T2D," the researchers wrote.

Diabetes management relies on maintaining blood glucose levels within an optimal range to prevent complications. The researchers note that traditional glucose monitoring methods, such as self-monitoring of blood glucose (SMBG), provide only periodic readings, whereas RT-CGM offers continuous, real-time data. This allows individuals and healthcare providers to make more informed decisions regarding insulin dosing, diet, and lifestyle modifications.

Evangelos C. Rizos, School of Medical Sciences, University of Ioannina, Ioannina, Greece, and colleagues conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of RT and non-RT continuous glucose monitoring (CGM) on Type 1 diabetes, Type 2 diabetes, and diabetes during pregnancy (DiP) in comparison to self-monitoring of blood glucose (BGM).

For this purpose, the researchers searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials up to October 2024. The primary focus was to analyze the weighted mean change differences (WMCDs) and absolute differences from baseline in glycated hemoglobin (HbA1c), along with time in range (TIR%), time below range (TBR%), and time above range (TAR%).

Key findings were as follows:

• A total of 64 randomized controlled trials were analyzed.
• In Type 1 diabetes, real-time continuous glucose monitoring was more effective than blood glucose monitoring (BGM) in reducing HbA1c, increasing time in the target range (70–180 mg/dL), and decreasing time spent in both low (<70 mg/dL, <54 mg/dL) and high (>180 mg/dL, >250 mg/dL) glucose ranges.
• In Type 2 diabetes, RT-CGM led to better HbA1c reduction, increased time in the target range, and decreased time spent in high glucose levels (>180 mg/dL, >250 mg/dL) compared to BGM.
• In diabetes during pregnancy, RT-CGM improved time spent in the target range (63–140 mg/dL), but no significant benefits were observed for HbA1c reduction, time in low glucose range (<63 mg/dL), or time in high glucose range (>140 mg/dL).
• Non-RT CGM also significantly reduced HbA1c in Type 2 diabetes compared to BGM.

The findings support the growing adoption of RT-CGM as a valuable tool for diabetes management. By providing continuous glucose readings and alerts for hypo- or hyperglycemia, RT-CGM empowers individuals to take proactive measures in maintaining stable blood sugar levels. The study emphasizes the need for wider accessibility and integration of CGM technology into routine diabetes care, particularly for high-risk populations.

"As more research emerges, RT-CGM is expected to play an increasingly important role in personalized diabetes management, enhancing overall treatment outcomes and quality of life for individuals living with diabetes," the authors concluded.

Reference: https://doi.org/10.1089/dia.2024.0599