Blood Glucose Monitoring Devices and Digital Biomarkers in Diabetes: Effectiveness, Utilisation and Challenges: A Systematic Review
No Thumbnail Available
Date
2024-10-09
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
King's College London
Abstract
Abstract
Introduction: Diabetes management has advanced with the introduction of digital biomarkers
and blood glucose monitoring (BGM) devices, offering new avenues for improving glycemic
control. This systematic review evaluates the effectiveness, utilisation, and challenges of these
technologies in diabetes management.
Methodology: A comprehensive search was conducted in PubMed, Medline, and Embase for
studies published between 2014 and 2024. Eligible studies involved adult patients (aged ≥18)
with diabetes using wearable or body-mounted devices for glucose monitoring. The review
included continuous glucose monitoring (CGM) systems (e.g., Dexcom, Medtronic), flash
glucose monitoring (FGM) systems (e.g., Freestyle Libre), and self-monitoring of blood
glucose (SMBG) devices. A total of 27 studies were included, comprising RCTs, observational
studies, pilot studies, interventional studies, and quasi-experimental studies.
Results: CGM systems demonstrated significant improvements in glycemic control, with
reductions in HbA1c ranging from 0.6% to 1.1% and improvements in time in range (TIR)
from 43% to 59%. FGM systems showed an average HbA1c reduction of 0.44% and a
significant decrease in hypoglycemic events, particularly nighttime hypoglycemia (a 0.29-hour
reduction, p=0.0001). While SMBG proved effective for real-time glucose monitoring, it
showed lower adherence rates and a limited impact on long-term glycemic outcomes compared
to CGM and FGM. Across studies, CGM outperformed FGM and SMBG in minimising
glycemic variability (GV) (27% vs 29%, p=0.05) and improving patient satisfaction. However,
challenges related to device cost, accessibility, and adherence, particularly for SMBG, remain
prevalent.
Conclusion: CGM and FGM offer substantial benefits over traditional SMBG, particularly in
reducing HbA1c, improving TIR, and decreasing hypoglycemic events. While these advanced
glucose monitoring systems provide significant clinical advantages, barriers such as cost and
complexity must be addressed to ensure broader adoption and improved health outcomes for
diabetes patients globally
Description
Keywords
Diabetes, Digital Biomarkers, CGM, Continuous Glucose Monitoring, Patient outcome, health outcome, Clinical outcome