Continuous Glucose Monitoring to Guide Lifestyle Choices With a Focus on Nutrition in the Management of Type 2...

The objective of this systematic review and meta-analysis was to synthesize evidence from randomized controlled trials (RCTs) evaluating the use of continuous glucose monitoring (CGM) to guide lifestyle choices, particularly nutrition, in the management of T2D.

PubMed and Cochrane CENTRAL were searched from inception to June 6, 2025. Randomized controlled trials were included if their intervention involved the use of a CGM device and education or feedback intended to modify nutrition choices, either as part of a nutrition intervention or a multicomponent lifestyle intervention. Random-effects meta-analyses were performed, and certainty of evidence was rated in alignment with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

A total of 21 RCTs involving 2734 adults in groups of interest were included, with 20 RCTs eligible for meta-analysis. Results from meta-analysis showed statistically significant improvements in HbA1c (MD: -0.46%, 95% CI: -0.71, -0.22), time in range (TIR) 70-180 mg/dL (MD: 7.18%, 95% CI: 2.77, 11.58), time above range (TAR) >180 mg/dL (MD: -7.32%, 95% CI: -12.98, -1.66), fasting glucose (MD: -7.86 mg/dL, 95% CI: -15.06, -0.65), body weight (MD: -2.06 kg, 95% CI: -3.74, -0.38), with moderate certainty of evidence, and for mean CGM glucose (MD: -11.57 mg/dL, 95% CI: -22.58, -0.56), and standard deviation (SD) glucose (MD: -4.06 mg/dL, 95% CI: -6.54, -1.58), with low certainty of evidence. No statistically significant differences were found for other outcomes, typically with low certainty of evidence.

Findings from this systematic review and meta-analysis support the use of CGM as a tool to guide lifestyle choices with a focus on nutrition in the management of T2D, with significant benefits related to glycemia and body weight.