Continuous Glucose Monitoring for Adult ICU Patients: A Meta-Analysis on Its Clinical Effectiveness

Critically ill patients often suffer from disrupted glucose metabolism, and well-managed blood glucose is a key determinant of clinical outcomes. While continuous glucose monitoring (CGM) is regarded as a viable alternative, its overall effectiveness in adult ICU patients remains controversial. This study aims to conduct a systematic evaluation on the effects of CGM versus conventional intermittent blood glucose monitoring on glycemic management among adult critically ill patients in ICUs. Literature searches were carried out across seven electronic databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data and VIP, from database inception up to May 18, 2026. Included studies were RCTs that compared CGM with conventional intermittent glucose monitoring in adult ICU patients. A total of 22 eligible RCTs with 1,396 enrolled patients were incorporated into the meta-analysis. The pooled estimates showed that CGM was associated with a significant reduction in hypoglycemic events (RR = 0.41, 95% CI: 0.31-0.54, I² = 24.9%) and average blood glucose levels (MD = -0.34 mmol/L, 95% CI: -0.55 to -0.13, I² = 68.3%). The intervention also prolonged time in glycemic target range (MD = 10.12%, 95% CI: 6.03%-14.21%, I² = 67.5%), cut down daily insulin use (MD = -22.17 U/day, 95% CI: -26.82 to -17.52, I² = 37.7%), and reduced total mortality (RR = 0.47, 95% CI: 0.34-0.65, I² = 0.0%). Our results suggest integrating CGM into routine ICU glycemic control strategies, particularly for patients with severe glycemic variability and high hypoglycemia risk.