Cystic fibrosis

The review included data from 17 studies of over 400 patients using continuous glucose monitors (CGM).

There is consensus on key CGM metrics and targets in type 1 diabetes with one of the core metrics being time in range specified as 70–180 mg/dL (3.9–10 mmol/L),” explained the researchers. Just 1 of the studies reported on patient satisfaction with their CGM system. There was 1 study that found a weighted mean difference of –4.8 mmol/mol (95% CI, –17.2 to 7.6) at over 7 months of follow-up. “However, the magnitude of difference in HbA1c between CGM and SMBG groups was greater in our study than those reported in type 1 diabetes cohorts (–0.4% vs -0.26%) which indicate that our findings likely over-estimate CGM effect. Data from 17 studies of over 400 patients found that CGM was associated with improved glycemic control, with a 4.1 mmol/mol (0.4%) reduction in HbA1c after at least 6 weeks of use. The researchers of the analysis also explored the impact of the glucose monitoring approaches on pulmonary outcomes, noting that evidence is lacking. Therefore, we propose that pulmonary function should be considered the primary outcome and we found currently there is insufficient evidence to support disease-specific CGM targets in CFRD.” “Microvascular complications are the principal disease-specific outcome in type 1 diabetes and studies have demonstrated correlations between time in range on CGM and complications. “Our findings are consistent with multiple systematic reviews evaluating data from randomised controlled trials in type 1 diabetes which have demonstrated that use of CGM is associated with improved glycemic control as evidenced by reduction in HbA1c when compared to SMBG,” wrote the researchers. A subgroup meta-analysis showed that glycemic control improved as duration of CGM use increased, with a weighted mean difference of –3.5 mmol/mol (95% CI, –5.6 to –1.5, p = .60) at 2-3 months, which increased to a weighted mean difference of -8.0 mmol/mol (95% CI, –15.6 to –0.3, P = –.96) at 4-6 months. One study showed that among 7 patients using CGM, there was an overall reduction in FEV1 of 4% while another showed an overall improvement of 8.4% in FEV1 in 78% of 18 patients using CGM over a 12-month period. Among the 138 patients using CGM, the weighted mean difference in HbA1c from baseline to follow-up was –3.9 mmol/mol (95% CI, –5.9 to –2.0; P < .0001) compared with –3.0 mmol/mol (95% CI, –7.5 to 1.5; P = 0.93) among the 278 patients who self-monitored their glucose