PT - JOURNAL ARTICLE AU - Castellana, Marco AU - Parisi, Claudia AU - Di Molfetta, Sergio AU - Di Gioia, Ludovico AU - Natalicchio, Annalisa AU - Perrini, Sebastio AU - Cignarelli, Angelo AU - Laviola, Luigi AU - Giorgino, Francesco TI - Efficacy and safety of flash glucose monitoring in patients with type 1 and type 2 diabetes: a systematic review and meta-analysis AID - 10.1136/bmjdrc-2019-001092 DP - 2020 Jun 01 TA - BMJ Open Diabetes Research & Care PG - e001092 VI - 8 IP - 1 4099 - http://drc.bmj.com/content/8/1/e001092.short 4100 - http://drc.bmj.com/content/8/1/e001092.full SO - BMJ Open Diab Res Care2020 Jun 01; 8 AB - Introduction Flash glucose monitoring (FGM) is a factory-calibrated sensor-based technology for the measurement of interstitial glucose. We performed a systematic review and meta-analysis to assess its efficacy and safety in patients with type 1 and type 2 diabetes.Research design and methods PubMed, CENTRAL, Scopus and Web of Science were searched in July 2019. Twelve studies with a follow-up longer than 8 weeks, evaluating 2173 patients on prandial insulin, multiple daily insulin injections or continuous subcutaneous insulin infusion were included. The following data were extracted: HbA1c, time in range, time above 180 mg/dL, time below 70 mg/dL, frequency of hypoglycemic events, number of self-monitoring of blood glucose (SMBG) measurements, total daily insulin dose, patient-reported outcomes, adverse events, and discontinuation rate. A comparison with SMBG was conducted.Results FGM use was associated with a reduction in HbA1c (−0.26% (−3 mmol/mol); p=0.002) from baseline to the last available follow-up, which correlated with HbA1c levels at baseline (−0.4% (−4 mmol/mol) for each 1.0% (11 mmol/mol) of HbA1c above 7.2% (55 mmol/mol)). Also, a decrease in time below 70 mg/dL was found (−0.60 hours/day; p=0.04). Favorable findings in patient-reported outcomes and no device-related serious adverse events were reported. When compared with SMBG, FGM was characterized by no statistically different change in HbA1c (p=0.09), with lower number of SMBG measurements per day (−3.76 n/day; p<0.001) and risk of discontinuation (relative risk=0.42; p=0.001). A limited number of studies, with a heterogeneous design and usually with a short-term follow-up and without specific training, were found.Conclusions The present review provides evidence for the use of FGM as an effective strategy for the management of diabetes.