Sistemas de monitorización continua de glucosa en tiempo real

Executive summary
Introduction
The real time continuous glucose monitoring system (CGMS-RT) uses minimally
invasive devices to measure glucose levels in interstitial fluid surrounding
the cells of the skin, giving more information on blood glucose fluctuations
and providing a broader view of glucose levels throughout the day.
Objectives
To analyze the scientific evidence on the efficacy and safety of CGMS-RT,
for glucose control, in comparison with the self-monitoring blood glucose
system in adults, for paediatric and adult patients with diabetes mellitus
type 1 (DM1).
Methodology
A systematic review of the scientific literature was conducted by searching
for papers published from 2006 until July 2010 in the main bibliographic
databases, to find clinical practice guidelines, reports, reviews and metaanalysis,
and original studies in adults and paediatric population with
DM1. The objective is to compare the use of CGMS-TR, with or without
continuous subcutaneous insulin infusion (CSII), with the standard Self-
Monitoring of Blood Glucose (SMBG). Outcomes were: glycated haemoglobin
(HbA 1C
) as a measure of metabolic control, frequency or duration
of episodes of hypo- or hyperglycaemia, safety, acceptability and health
related quality of life (HRQoL). For the assessment of methodological
quality of the identified publications, the criteria of Scottish Intercollegiate
Guidelines Network (SIGN) were used. Data from accepted studies
were abstracted into evidence tables.
Results
Fourteen randomized controlled trials and 2 before and after studies were
selected. Of these studies, 7 were carried out in adults, 2 in children and 7,
in mixed-age sample. The methodological quality of the studies was considered
moderate. In general, the use of CGMS-RT decreased HbA 1C
levels,
but only in few cases significant differences were found in adults and paediatrics
compared to the SMBG. The results on the frequency and duration of
hypo and hyperglycaemia were quite variable with a tendency of their better
SISTEMAS DE MONITORIZACIÓN CONTINUA DE GLUCOSA EN TIEMPO REAL
13