Type 2 diabetes is highly prevalent, and many adults, especially those not using insulin, struggle to reach HbA1c targets. This review aimed to evaluate the effect of self-monitoring blood glucose (SMBG) and continuous glucose monitoring (CGM) on glycaemic control in adults with type 2 diabetes. We searched MEDLINE, Cochrane Library, Embase, and Scopus from January 2014 to May 2025 for systematic reviews of randomized controlled trials enrolling adults with type 2 diabetes that evaluated SMBG or CGM versus no monitoring or SMBG, respectively. Fifteen systematic reviews comprising 81 unique studies and 23 657 participants were included. Reviews comparing SMBG with no monitoring demonstrated a modest but significant reduction in HbA1c (MD -0.23%, 95% CI -0.29 to -0.18; I2 = 21%). Reviews directly comparing CGM with SMBG showed greater HbA1c reduction with CGM (MD -0.29%, 95% CI -0.34 to -0.24; I2 = 0%). Subgroup analyses for SMBG indicated consistent benefits across follow-up duration, monitoring structure, and study quality, although heterogeneity was high in some comparisons. Subgroup analyses for CGM types found both isCGM/FGM (MD -0.27%, 95% CI -0.43 to -0.11) and rtCGM (MD -0.36%, 95% CI -0.45 to -0.27) superior to SMBG. These findings support glucose monitoring for optimizing glycaemic management and outcomes. Further investment in cost-effectiveness studies is warranted to assess broader implementation in this population.
| Discipline Area | Score |
|---|---|
| Family Medicine (FM)/General Practice (GP) |  |
| General Internal Medicine-Primary Care(US) | |
| Endocrine | Coming Soon... |
Glucose-monitoring technologies have developed rapidly in the past decades. Practitioners (including specialists) are unfamiliar with many of the novel technologies.
As someone working with geromedicine and lifestyle medicine, this paper is interesting because it shows with high consistency that in non-insulin-treated T2D, CGM improves HbA1c more than SMBG, and SMBG improves HbA1c more than no monitoring, with small but robust effect sizes. Of note, earlier reviews questioned the utility of structured and digital monitoring in non–insulin–treated T2D, reporting inconsistent outcomes and only modest HbA1c reductions.
