Presentation (CTI)

OBJECTIVES: Continuous glucose monitoring (CGM) has demonstrated clinical benefits in people with type 2 diabetes mellitus (T2DM), including improvements in glycemic control and reductions in HbA1c. This systematic literature review aimed to identify and evaluate cost-effectiveness evidence comparing CGM vs. self-monitoring of blood glucose (SMBG) among adults with T2DM.
METHODS: A systematic search was performed in Embase and PubMed (including MEDLINE) for studies published from inception to May 27, 2026 (PROSPERO registration: CRD420261396474). Studies reporting on the cost-effectiveness of CGM vs. SMBG, or a clinically comparable alternative, among adults with T2DM were included. Data were extracted manually and synthesized narratively. Study details, population and setting characteristics, clinical and methodological assumptions, and results were evaluated. Quality of evidence and risk of bias were assessed.
RESULTS: A total of 486 records were screened, with 26 studies included for analysis. The majority of studies (n=17) were published after 2023 (publication year ranged from 2016-2026), with analyses conducted predominantly in European or North American settings (n=17); only three analyses were performed in low- and middle-income countries (LMIC). On average and where reported, the mean patient age was 60.8 years, 43.7% were female, mean baseline HbA1c was 8.6%, and mean duration of diabetes was 14.5 years. CGM was cost-effective in 23 out of 26 studies. Key determinants of cost-effectiveness included the cost and frequency of CGM, utility assumptions, and clinical effectiveness assumptions (HbA1c reduction). Across the included studies, quality of evidence was moderate.
CONCLUSIONS: Contemporary economic evidence supports the cost-effectiveness of CGM in adults with T2DM across a range of geographies. Further analyses, including longitudinal clinical evidence and analyses performed in LMIC settings, are needed to support the broader generalizability of these findings.