The effect of real time continuous blood glucose monitoring system versus intermittent blood glucose monitoring in critically ill patients under the intensive insulin therapy: a Meta-analysis

Abstract

Objective To evaluate the value of real time continuous blood glucose monitoring system (RT-CGMS) versus intermittent blood glucose monitoring (IGM) in the critically ill patients under intensive insulin therapy (IIT) . Methods A systematic searching randomized and controlled trials (RCT) in databases was performed for meta-analysis by Review Manager 5.2 software. Outcomes were hypoglycemia episode, alteration of mean blood glucose level, the percentage of time at a blood glucose level within optimal target range, and the early mortalities. Results Six studies, totally 531 patients, were included in this meta-analysis. The pooled SMD of mean blood glucose level was =-0.21 (95% SMD: -0.43 - 0.01, P =0.07) . The pooled SMD of percentage of time at a blood glucose level within optimal target range was 0.20 (95% SMD: -0.09 -0.49, P =0.18) . The pooled OR of hypoglycemia episode frequency was 0.20 (95% CI: 0.09 -0.43, P <0.01) . The pooled OR of early mortalities was 0.35 (95% CI: 0.14 -0.89, P =0.03) . Conclusions In critically ill patients under the intensive insulin therapy, RT-CGMS had obvious beneficial effect on reducing hypoglycemic events. RT-CGMS had no obvious beneficial effect on keeping blood glucose level within optimal target range. Key words: Critically ill patients; Real time continuous glucose monitoring system; Intensive insulin therapy; Meta-analysis