Continuous glucose monitoring: A review of the evidence in type 1 and 2 diabetes mellitus.

Abstract

Continuous glucose monitoring is becoming widely accepted as an adjunct to diabetes management. Compared to standard care, continuous glucose monitoring can provide detailed information about glycaemic variability in an internationally standardised ambulatory glucose profile, enabling more informed user and clinician decision-making. We aimed to review the evidence, user experience, and cost-effectiveness of continuous glucose monitoring. A literature search was conducted by combining subject headings "continuous glucose monitoring" and "flash glucose monitoring", with key words "type 1 diabetes" and "type 2 diabetes", limited to "1999 to current". Further evidence was obtained from relevant references of retrieved articles. There is strong evidence for continuous glucose monitoring use in people with type 1 diabetes, with benefits of reduced glycated haemoglobin and hypoglycaemia, and increased time in range. While the evidence for continuous glucose monitoring use in type 2 diabetes is less robust, similar benefits have been demonstrated. Continuous glucose monitoring can improve diabetes-related satisfaction in people with diabetes and parents of children with diabetes, as well as the clinician experience. However, continuous glucose monitoring does have limitations including cost, accuracy and perceived inconvenience. Cost-effectiveness analyses have indicated that continuous glucose monitoring is a cost-effective adjunct to type 1 diabetes management that is associated with reduced diabetes-related complications and hospitalisation. Continuous glucose monitoring is revolutionising diabetes management. It is a cost-effective adjunct to diabetes management that has the potential to improve glycaemic outcomes and quality of life in people with diabetes, especially type 1 diabetes.