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Optimizing Glycemic Control Using Continuous Glucose Monitoring: An Umbrella Review of Systematic Reviews and

Hana A Al-Abdulkarim^1,2, Mohammad Al-Shraim², Hossein Motahari-Nezhad³

¹Doctoral School of Applied Informatics and Applied Mathematics, Óbuda University, Budapest, Hungary.

Journal of Diabetes Science and Technology

|May 23, 2026

Summary

Continuous glucose monitoring (CGM) significantly reduces HbA1c in diabetes patients compared to self-monitoring of blood glucose (SMBG). However, high unexplained heterogeneity necessitates cautious generalization of results across diverse clinical settings.

Keywords:

blood glucose self-monitoring continuous glucose monitoring diabetes mellitus

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Published on: February 24, 2023

Area of Science:

Endocrinology and Metabolism
Medical Devices and Technology
Diabetes Management

Background:

Continuous glucose monitoring (CGM) devices offer real-time blood glucose tracking for diabetes management.
Existing systematic literature reviews (SLRs) have explored CGM efficacy against self-monitoring of blood glucose (SMBG).

Purpose of the Study:

To conduct an umbrella review of SLRs and a primary-level meta-analysis comparing CGM and SMBG efficacy.
To evaluate the impact of CGM on glycated hemoglobin (HbA1c) levels across diverse patient populations.

Main Methods:

Systematic search of PubMed, EMBASE, and Web of Science databases (January 2000 - February 2024).
Quantitative synthesis of primary studies from included SLRs to avoid data overlap.
Appraisal of SLR quality using AMSTAR-2 and GRADE tools.
Random-effects meta-analysis and meta-regression to assess HbA1c reduction and explore heterogeneity.

Main Results:

Included 40 SLRs encompassing 78,261 patients.
CGM demonstrated a significant reduction in HbA1c compared to the control group (mean difference: 0.31%).
High unexplained heterogeneity (I² = 89.7%) was observed across studies.

Conclusions:

This study provides the first primary-level meta-analysis overview of CGM efficacy across all diabetes types and ages.
CGM offers a significant benefit in reducing HbA1c.
The substantial unexplained heterogeneity warrants caution when generalizing findings, as benefits may vary by clinical setting.