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Journal ArticleDOI

Real‐time continuous glucose monitoring system for treatment of diabetes: a systematic review

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TLDR
In this paper, a systematic search was performed in PubMed/MEDLINE and EMBASE for randomized controlled trials comparing real-time continuous glucose monitoring systems with self-monitoring blood glucose or non-real-time continuously glucose monitoring system.
Abstract
Diabet. Med. 28, 386–394 (2011) Abstract Aims  This study reviews the effect of real-time continuous glucose monitoring systems in diabetes management. Methods  A systematic search was performed in PubMed/MEDLINE and EMBASE for randomized controlled trials comparing real-time continuous glucose monitoring systems with self-monitoring blood glucose or non-real-time continuous glucose monitoring systems. Results  Nine randomized controlled trials were identified. Two studies used a device which is not on the market any more. In this review we focus on the other seven studies. Performing a meta-analysis was not possible because of extensive clinical heterogeneity. Six of seven studies showed some positive effect of real-time continuous glucose monitoring systems on HbA1c (HbA1c decrease 0.3–0.7% or 3–8 mmol/mol). In some studies, this effect only was shown in subgroups (compliant adult patients). However, the size of effect may be underestimated by better-than-average results in the control group, as self-monitoring blood glucose measurements are carried out more frequently than in usual clinical practice. Despite the goal of lowering HbA1c, no more severe hypoglycaemic episodes were seen, except in one study. In contrast, no positive effect was shown with the real-time continuous glucose monitoring system on hypoglycaemia, but randomized controlled trials were not designed or powered to investigate this issue. Time in different glucose strata was assessed only in some trials: two of them showed a significant but small increase in time in euglycaemia. Conclusions  Current evidence shows that the real-time continuous glucose monitoring system has a beneficial effect on glycaemic control in adult diabetes patients, without an increase in the incidence of hypoglycaemia. Studies in well-selected patient groups (pregnancy, history of severe hypoglycaemias, Type 2 diabetes) are lacking.

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TL;DR: This update builds on the original IDF Guideline for the Management of PostMeal Glucose published in 2007 and will consider the need to review and update this guideline within three to five years.
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The Effect of Real-Time Continuous Glucose Monitoring in Pregnant Women With Diabetes: A randomized controlled trial

TL;DR: In this randomized trial, intermittent use of real-time CGM in pregnancy, in addition to self-monitored plasma glucose seven times daily, did not improve glycemic control or pregnancy outcome in women with pregestational diabetes.
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Closed-Loop Basal Insulin Delivery Over 36 Hours in Adolescents With Type 1 Diabetes: Randomized clinical trial

TL;DR: Day-and-night closed-loop basal insulin delivery can improve glucose control in adolescents, however, unannounced moderate-intensity exercise and excessive prandial boluses pose challenges to hypoglycemia-free closed- loop basal insulin Delivery.
References
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Journal ArticleDOI

The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.

TL;DR: Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
Journal Article

Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

R C Turner, +398 more
- 12 Sep 1998 - 
TL;DR: In this article, the effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.

Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

TL;DR: The effects of intensive blood-glucose control with either sulphonylurea or insulin and conventional treatment on the risk of microvascular and macrovascular complications in patients with type 2 diabetes in a randomised controlled trial were compared.
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