Running head: CONTINUOUS GLUCOSE MONITORING 1
Effects of Continuous Glucose Monitoring on Reducing Diabetes Complications
Stephanie Miller
Medical University of South Carolina
CONTINUOUS GLUCOSE MONITORING
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Diabetes Complications and Death
Diabetes is the 7th leading cause of death in the United States today. In the vast majority of
cases, it was a complication from the diabetes that ultimately lead to death (American Diabetes
Association, 2016). Complications of diabetes are vast and include cardiovascular disease, renal
failure, stroke, neuropathy, blindness, and amputation (Fukanaga, Uehara, & Tom, 2011). Studies
show that there is a direct correlation between maintaining a hemoglobin A1C of 7% or below and
lower risk of complications from diabetes mellitus (Timar & Albai, 2012).
While lower hemoglobin A1c levels consistently correlate with improved patient outcomes,
maintaining a desired range is not easy for all patients – specifically those with type 1 diabetes
mellitus. In fact, only about 30% of individuals with type 1 diabetes are able to meet the target
A1C goal (Beck et al., 2017). In recent years, continuous glucose monitors have become available
for personal use to patients with type 1 diabetes. The purpose of this review is to examine the
literature related to the effectiveness of continuous glucose monitors on lowering hemoglobin A1C
levels in adult patients with type 1 diabetes mellitus, and thus reducing their risk of diabetes related
complications.
The PICOT Question
In adult patients with Type 1 Diabetes Mellitus, does continuous glucose monitoring
consistently lower hemoglobin A1C levels compared to patients checking a finger stick blood
glucose level 3-5 times a day?
Search Strategies
Using words and phrases derived from the PICO question, a literature search was conducted
within PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) using
the search terms, continuous glucose monitoring, type 1 diabetes, and effects on A1C. CINAHL
did not yield any full-text articles, but PubMed yielded 181 total results, including 85 clinical trials
CONTINUOUS GLUCOSE MONITORING
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and 19 systematic reviews. Reading the titles helped to narrow the results to relevant articles, and
reading the abstracts and in some cases the first few pages narrowed it down even more to 5 articles
that will be reviewed in this paper.
CONTINUOUS GLUCOSE MONITORING 4
Literature Table
Citation
Purpose
Design/Method
Sample/Setting
Study finding
Study strengths
& weaknesses
Significance for
Practice
Beck et al., (2017)
JAMA
To determine the
effectiveness of
continuous
glucose
monitoring
(CGM) in adults
with type 1
Randomized
clinical trial
Included 158
adults with type 1
diabetes who were
using multiple
Random
assignment 2:1 to
CGM (n = 105) or
usual care
(control group;
n = 53)
Among adults
with type 1
diabetes who used
multiple daily
insulin injections,
the use of CGM
compared with
Strengths:
Randomized
selection
Weaknesses:
Small sample size
Continuous glucose
monitoring is more
effective in lowering
hemoglobin A1C in
patients with type 1
diabetes than using a
traditional glucose