Real-time continuous glucose monitoring in type 1 diabetes: a systematic review and individual patient data meta-analysis

التفاصيل البيبلوغرافية
العنوان: Real-time continuous glucose monitoring in type 1 diabetes: a systematic review and individual patient data meta-analysis
المؤلفون: Shrikant Tamhane, Irl B. Hirsch, Jean Pierre Riveline, Mohammad Hassan Murad, Larry J. Prokop, Zhen Wang, Denis Raccah, Khalid Benkhadra, Fares Alahdab, Olga Kordonouri
المصدر: Clinical Endocrinology. 86:354-360
بيانات النشر: Wiley, 2017.
سنة النشر: 2017
مصطلحات موضوعية: Adult, Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, MEDLINE, Monitoring, Ambulatory, 030209 endocrinology & metabolism, law.invention, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Randomized controlled trial, law, Diabetes mellitus, Internal medicine, Humans, Insulin, Medicine, 030212 general & internal medicine, Randomized Controlled Trials as Topic, Glycated Hemoglobin, Type 1 diabetes, business.industry, Incidence, Incidence (epidemiology), Age Factors, nutritional and metabolic diseases, Middle Aged, medicine.disease, Hypoglycemia, Confidence interval, Diabetes Mellitus, Type 1, Systematic review, Meta-analysis, Female, business
الوصف: Background Real-time continuous glucose monitoring (RTCGM) may help in the management of individuals with type 1 diabetes mellitus (T1DM); however, the evidence supporting its use is unclear. The available meta-analyses on this topic use aggregate data which weaken inference. Objective Individual patient data were obtained from randomized controlled trials (RCTs) to conduct a meta-analysis and synthesize evidence about the effect of RTCGM on glycosylated haemoglobin (HbA1c), hypoglycaemic events and time spent in hypoglycaemia in T1DM. Methods We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, and Scopus through January 2015. We included RCTs that enrolled individuals with T1DM and compared RTCGM vs control group. A two-step regression model was used to pool individual patient data. Results We included 11 RCTs at moderate risk of bias. Meta-analysis suggests that the use of RTCGM is associated with a statistically significant but modest reduction in HbA1c (−0·276; 95% confidence interval −0·465 to −0·087). The improvements in HbA1c were primarily seen in individuals over age 15 years. We were unable to identify a statistically significant difference in time spent in hypoglycaemia or the number of hypoglycaemic episodes although these analyses were imprecise and warrant lower confidence. There was no difference between males and females. Conclusion RTCGM in T1DM is associated with a reduction in HbA1c primarily in individuals over 15 years of age. We were unable to identify a statistically significant difference in the time spent in hypoglycaemia or the incidence of hypoglycaemic episodes.
تدمد: 0300-0664
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::47f76cc9ea5fd3048a311011eb94e437Test
https://doi.org/10.1111/cen.13290Test
حقوق: CLOSED
رقم الانضمام: edsair.doi.dedup.....47f76cc9ea5fd3048a311011eb94e437
قاعدة البيانات: OpenAIRE