Continuous Glucose Monitoring System in children with type 1 diabetes mellitus: a systematic review and meta-analysis.
OBJECTIVE
We investigated the potential effects of the Continuous Glucose Monitoring System (CGMS), as compared with self-monitoring of blood glucose, on glycaemic control in children with type 1 diabetes.


METHODS
The following electronic databases were searched throughout June 2007: MEDLINE, EMBASE and The Cochrane Library. Additional references were obtained from reviewed articles. Only randomised controlled trials were included.


RESULTS
We included five trials involving 131 type 1 diabetic patients in the study. Combined data from all trials showed that the CGMS did not significantly reduce HbA1c levels compared with control groups. The pooled weighted mean difference was -0.02% (95% CI -0.29 to 0.25) with a fixed model and remained insignificant in the random effect model. Sensitivity analysis determined that the findings were stable. There was a trend towards a longer time under the CGMS curve for glucose <3.89 mmol/l in the CGMS group compared with the control group (mean difference 49.00 min, 95% CI -18.00 to 116.00). The CGMS significantly increased the number of insulin dose changes per patient per month for those managed with CGMS compared with the control groups (mean difference 6.3 changes, 95% CI 2.88-9.72).


CONCLUSIONS
The Continuous Glucose Monitoring System is not better than self-monitoring of blood glucose with regard to improvement of metabolic control among type 1 diabetic children. However, due to the small number of participants and methodological limitations of the studies included, findings of this meta-analysis should be interpreted with caution.
Department of Pharmacoeconomics, Medical University of Warsaw, ul. Pawinskiego 3A, 02-106, Warsaw, Poland. dgolicki@amwaw.edu.pl
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Golicki
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Golicka
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Groele
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Pankowska
D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods*; D016206:Databases, Bibliographic; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D006801:Humans; D016239:MEDLINE; D018670:Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
D001786:Blood Glucose