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Learning Objective 1: The learner will be able to state the difference between continuous glucose monitoring and self-glucose monitoring in adolescents with type 1 diabetes.
Learning Objective 2: The learner will be able to state the importance of hemoglobin A1C and hypoglycemia as metabolic outcome measures in relation to type 1 diabetes.
Inclusion criteria:
Type of participants- adolescent patients, aged 13 to 19 years, in the outpatient setting with type 1 diabetes mellitus utilizing a continuous subcutaneous insulin pump
Type of intervention- studies evaluating continuous glucose monitoring compared to self-glucose monitoring alone, in adolescents utilizing a continuous subcutaneous insulin infusion
Type of studies- randomized control trials (RCTs), quasi-experimental studies were considered only in absence of RCTs
Type of outcomes- studies examining the following outcome measures: number of hypoglycemic episodes and hemoglobin A1C level
Search strategy: The search strategy included studies published between 2002 and 2012, in or translated into English.
Methodological quality: Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Any disagreement between the reviewers was resolved through discussion.
Data collection: Data was extracted from papers included in the review using the standardised data extraction tool from JBI-MAStARI.
Data synthesis: Quantitative papers were pooled in statistical meta-analysis using JBI-MAStARI.
Results: There is no statistically significant difference in levels of hemoglobin A1C in adolescents on Continuous Subcutaneous Insulin Infusion (CSII) utilizing continuous glucose monitoring as compared to those utilizing self-glucose monitoring alone.
Conclusions: The utilization of CGM in conjunction with a CSII does not improve hemoglobin A1C levels when compared with self-glucose monitoring in adolescent patients with type 1 diabetes. Limit data suggests outpatient adolescents with type 1 diabetes on a CSII utilizing a CGM is an area not well investigated or understood.