945-P: Effect of Real-Time Continuous Glucose Monitoring vs. Flash Glucose Monitoring on Glycemic Control and Glycemic Variability in Patients with Type 1 Diabetes—A Systematic Review and Meta-analysis

Abstract

Objectives: Previous studies have shown that real-time continuous glucose monitoring (rtCGM) and flash glucose monitoring (FGM) led to different impacts on glycemic control and glycemic variability in patients with T1D. This meta-analysis aimed to summarize data and compare the effect of the rtCGM and FGM in patients with T1D. Methods: A systematic literature searches of all relevant studies comparing the clinical effectiveness of rtCGM and FGM in T1D on Cochrane Library, PubMed, Embase, Web of Science, and Scopus before October 2022 were performed. Two independent reviewers searched and assessed all literatures according to the standard of Cochrane systematic review. Data extraction and quality assessment were conducted. Stata 15.1 software was used for data analysis. The random effects model was used since there was heterogeneity between studies. Results: Eight studies including three randomized controlled trials and five observational studies conducting in 1649 TID patients were enrolled in this meta-analysis. It was found that there was no difference in reduction of HbA1c levels between rtCGM and FGM. In terms of indexes of glycemic variability, compared to FGM, rtCGM led to better TIR (3.9~10 mmol/L) (SMD = 0.721, 95%CI: 0.438 ~ 1.003, P<0.001), lower TBR (<3.9mmol/L) (SMD = -1.441, 95%CI: -2.090 ~ -0.791, P<0.001), lower TAR (TAR>10.0mmol/L: SMD = -0.299, 95%CI: -0.583 ~ -0.015, P = 0.039; TAR>13.9 mmol/L: SMD = -0.395, 95%CI: -0.702 ~ -0.088, P = 0.012), lower standard deviation (SMD = -0.769, 95%CI: -1.097 ~ -0.442, P<0.001), and lower glucose coefficient of variation (SMD = -0.859, 95%CI: -1.159 ~ -0.559, P<0.001) as well. However, there was no difference between rtCGM and FGM in lowering mean glucose and TBR (<3.0mmol/L). Conclusions: rtCGM accounted for favorable outcomes on improving glycemic variability indices but not HbA1c reduction compared to FGM in patients with T1D. Disclosure D.Chen: None. Z.Liu: None. B.Lin: None. Y.Yang: None. D.Yang: None. J.Yan: None. W.Xu: None. Funding SHMHDF (DMRFP_II_14)