A systematic review on clinical implication of continuous glucose monitoring in diabetes management.

Anam Azhar, Syed W Gillani, Ghasna Mohiuddin, Rukhsar A Majeed
Author Information
  1. Anam Azhar: Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE.
  2. Syed W Gillani: Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE.
  3. Ghasna Mohiuddin: Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE.
  4. Rukhsar A Majeed: Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE.

Abstract

OBJECTIVE: The aim of this systematic review was to evaluate the clinical implications of continuous glucose monitoring (CGM) among patients with diabetes mellitus using variables that include glycated hemoglobin (HbA1c), estimated A1c, glucose variability, and users' perspectives.
MATERIALS AND METHODS: This study analyzed 17 articles that were identified and studied according to the research question criteria. PRISMA guidelines were used for identification and screening of the literature. The required data were searched using Medscape, PubMed, PROSPERO, Wiley Library, Scopus, Clinical Trial Registry, and Trip.
RESULTS: The articles reviewed were on the use of CGM in type 1 and type 2 diabetes mellitus, which showed significant improvement in the levels of HbA1c as compared to non-CGM. The application of CGM on acute sudden onset type of adverse drug reactions (i.e., hypoglycemia) is better than fasting blood sugar or self-monitoring of blood glucose or capillary blood glucose (random blood glucose monitoring). CGM is beneficial for use in patients with type 2 diabetes mellitus including elderly patients as it gives information regarding glucose variability as well as HbA1c levels. The health-care providers require full spectrum of patients' CGM data to design a better therapeutic plan. However, the patients experienced inconvenience on wearing the device on the body for longer periods. The findings also stated the fact that more education and training is required for the patients to interpret their own glycemic data using CGM and modify their lifestyle accordingly. Use of CGM along with HbA1c has also been used to achieve better glycemic results and it allows the health care professional to guide patients in terms of their glucose level; whether they are hypoglycemic or hyperglycemic, however its use has some controversies that minimize its application.
CONCLUSION: The study concluded that CGM has significant potential in the management of not only patients with type 1 diabetes mellitus but also patients with type 2 diabetes mellitus in spite of the few limitations that are being improvised in the upcoming years. However, limited literature of CGM among patients with type 2 diabetes mellitus and pregnant women reduces the practice scope.

Keywords

References

  1. J Diabetes Investig. 2018 Jan;9(1):69-74 [PMID: 28397367]
  2. Diabetes Technol Ther. 2017 Jun;19(S3):S25-S37 [PMID: 28585879]
  3. BMC Endocr Disord. 2018 Feb 20;18(1):12 [PMID: 29458348]
  4. N Engl J Med. 2008 Oct 2;359(14):1464-76 [PMID: 18779236]
  5. Diabetes Care. 2017 Dec;40(12):1614-1621 [PMID: 29070577]
  6. Diabet Med. 2011 Oct;28(10):1158-67 [PMID: 21294770]
  7. J Diabetes Sci Technol. 2018 Sep;12(5):1064-1071 [PMID: 29783897]
  8. Eur Endocrinol. 2018 Apr;14(1):24-29 [PMID: 29922348]
  9. Curr Ther Res Clin Exp. 2019 Apr 25;90:53-60 [PMID: 31193026]
  10. Crit Care. 2017 Jul 31;21(1):197 [PMID: 28756769]
  11. Diabetes Technol Ther. 2019 Feb;21(S1):S13-S31 [PMID: 30785326]
  12. Nurs Res. 2011 May-Jun;60(3):173-81 [PMID: 21522034]
  13. Diabetes Care. 2017 Dec;40(12):1631-1640 [PMID: 29162583]
  14. Diabetes Care. 2018 Nov;41(11):2275-2280 [PMID: 30224348]
  15. Diabetes Care. 2011 Nov;34(11):2403-5 [PMID: 21933908]
  16. J Pharm Pharm Sci. 2012;15(3):447-66 [PMID: 23148894]
  17. Med Devices (Auckl). 2017 Sep 12;10:215-224 [PMID: 28979168]
  18. J Diabetes Sci Technol. 2017 Sep;11(5):1028-1035 [PMID: 28290224]
  19. Diabetes Technol Ther. 2017 May;19(S2):S4-S11 [PMID: 28541137]
  20. Diabetes Ther. 2017 Dec;8(6):1405-1413 [PMID: 29086351]
  21. Diabetes Technol Ther. 2017 May;19(S2):S27-S36 [PMID: 28541132]
  22. Eur J Clin Invest. 2015 Nov;45(11):1161-74 [PMID: 26313310]
  23. Cardiovasc Diabetol. 2017 Aug 14;16(1):103 [PMID: 28807030]

Word Cloud

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