Continuous Glucose Monitoring versus Self-Monitoring of Blood Glucose for Glycemic Control in Adolescents with Type 1 Diabetes: A Systematic Review
Keywords:
Type 1 Diabetes, Adolescents, Continuous Glucose Monitoring, Self-Monitoring of Blood Glucose, Glycemic Control, Hemoglobin A1c
Abstract
Type 1 diabetes mellitus (T1D) is a chronic condition affecting children and adolescents, and inadequate glycemic control may increase the risk of acute and chronic complications and adversely affect quality of life. This systematic review aimed to synthesize evidence on the impact of adherence to blood glucose monitoring on glycemic control and to identify factors influencing monitoring adherence among children and adolescents with T1D. A systematic literature search was conducted in Scopus, PubMed, and ProQuest for studies published between 2021 and 2026. Study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The review protocol was registered in PROSPERO (CRD420261403299). The methodological quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool, and findings were synthesized narratively. Fifteen studies were included in the final review. The findings indicate that continuous glucose monitoring (CGM) is generally associated with improved glycemic control, including reductions in HbA1c, increased time in range, and reduced hypoglycemia in several study populations. Monitoring adherence was influenced by psychological factors, including diabetes-related distress and fear of glucose readings, as well as technological factors, family support, and healthcare-system factors. Overall, CGM may support glycemic management and monitoring adherence; however, its effectiveness depends on patient engagement, psychosocial support, access to technology, and appropriate clinical education. A multidisciplinary approach is therefore needed to optimize glucose-monitoring technologies and improve diabetes self-management among children and adolescents with T1D. These findings highlight importance of integrating technological, behavioral, and clinical support into diabetes care.
References
Arslan, B. C., Demet Akbaş, E., Ünal, A., Bozduman Çelebi, S., & Tolunay, O. (2025). Effects Of Diabetes-Related Distress on Diabetes Follow-Up in Adolescents with Type 1 Diabetes Mellitus. Cukurova Medical Journal, 50(4), 972–982. Https://Doi.Org/10.17826/CUMJ.1720329
Bisio, A., Anderson, S., Norlander, L., O’malley, G., Robic, J., Ogyaadu, S., Hsu, L., Levister, C., Ekhlaspour, L., Lam, D. W., Levy, C., Buckingham, B., & Breton, M. D. (2022). Impact Of A Novel Diabetes Support System on A Cohort of Individuals with Type 1 Diabetes Treated With Multiple Daily Injections: A Multicenter Randomized Study. Diabetes Care, 45(1), 186–193. Https://Doi.Org/10.2337/Dc21-0838
Chan, J., Jackson, N., Rebollar, A. G., Santana, C., De La Garza, G. P., Moin, T., Yee, J. K., & Everett, E. (2025). Association Between Self-Monitored Blood Glucose And Continuous Glucose Monitoring In Youth With Type 1 Diabetes And Medicaid Insurance. Diabetes Care, 48(4), 632–638. Https://Doi.Org/10.2337/Dc24-2224
Crossen, S. S., Romero, C. C., Lewis, C., & Glaser, N. S. (2023). Remote Glucose Monitoring Is Feasible For Patients And Providers Using A Commercially Available Population Health Platform. February, 1–8. Https://Doi.Org/10.3389/Fendo.2023.1063290
Datye, K. A., Tilden, D. R., Parmar, A. M., Goethals, E. R., & Jaser, S. S. (2021). Advances, Challenges, And Cost Associated With Continuous Glucose Monitor Use In Adolescents And Young Adults With Type 1 Diabetes. Current Diabetes Reports, 21(7), 22. Https://Doi.Org/10.1007/S11892-021-01389-1
Deshpande, S., Weinzimer, S. A., Gibbons, K., Nally, L. M., Weyman, K., Carria, L., Zgorski, M., Laffel, L. M., Iii, F. J. D., & Dassau, E. (2024). Feasibility And Preliminary Safety Of Smartphone-Based Automated Insulin Delivery In Adolescents And Children With Type 1 Diabetes. Https://Doi.Org/10.1177/19322968221116384
Elbarbary, N., Moser, O., Al Yaarubi, S., Alsaffar, H., Al Shaikh, A., Ajjan, R. A., & Deeb, A. (2021). Use Of Continuous Glucose Monitoring Trend Arrows In The Younger Population With Type 1 Diabetes. Diabetes & Vascular Disease Research, 18(6). Https://Doi.Org/10.1177/14791641211062155
Jalilova, A., Pilan, B. Ş., Demir, G., Özbaran, B., Balkı, H. G., Arslan, E., Köse, S. G., Özen, S., Darcan, Ş., & Gökşen, D. (2024). The Psychosocial Outcomes Of Advanced Hybrid Closed-Loop System In Children And Adolescents With Type 1 Diabetes. European Journal Of Pediatrics, 183(7), 3095–3103. Https://Doi.Org/10.1007/S00431-024-05551-1
Kartolo, A., Kassouf, W., & Vera-Badillo, F. E. (2021). Adjuvant Immune Checkpoint Inhibition In Muscle-Invasive Bladder Cancer: Is It Ready For Prime Time? European Urology, 80(6), 679–681. Https://Doi.Org/10.1016/J.Eururo.2021.07.019
Kidie, A. A., Lakew, A. M., & Ayele, T. (2021). Frequency Of Diabetic Ketoacidosis And Its Determinants Among Pediatric Diabetes Mellitus Patients In Northwest Ethiopia. Diabetes, Metabolic Syndrome And Obesity, 14, 4819–4827. Https://Doi.Org/10.2147/DMSO.S326537
Levy, C. J., Kudva, Y. C., Ozaslan, B., Castorino, K., O’malley, G., Kaur, R. J., Levister, C. M., Church, M. M., Desjardins, D., Mccrady-Spitzer, S., Ogyaadu, S., Trinidad, M. C., Reid, C., Rizvi, S., Deshpande, S., Zaniletti, I., Kremers, W. K., Pinsker, J. E., Doyle, F. J., & Dassau, E. (2023). At-Home Use Of A Pregnancy-Specific Zone-MPC Closed-Loop System For Pregnancies Complicated By Type 1 Diabetes: A Single-Arm, Observational Multicenter Study. Diabetes Care, 46(7), 1425–1431. Https://Doi.Org/10.2337/Dc23-0173
Madrigal, M. A., López, M., Sánchez, A., Cao, M. J., Castro, M. J., & Jiménez, J. M. (2020). Type 1 Diabetes Mellitus In Pediatric Patients And Its Impact On Relationships In The Family Environment. Diabetes, Metabolic Syndrome And Obesity, 13, 4973–4980. Https://Doi.Org/10.2147/DMSO.S281949
Muthoni L., K. (2025). The Impact Of Continuous Glucose Monitoring (CGM) Versus Self-Monitoring Of Blood Glucose (SMBG) On Glycemic Control In Adults With Type 2 Diabetes. RESEARCH INVENTION JOURNAL OF RESEARCH IN MEDICAL SCIENCES, 4(1), 1–5. Https://Doi.Org/10.59298/RIJRMS/2025/4115
O’Donnell, H. K., Vigers, T., Johnson, S. B., Pyle, L., Wright, N., Deeb, L. C., & Driscoll, K. A. (2021). Pump It Up! A Randomized Clinical Trial To Optimize Insulin Pump Self-Management Behaviors In Adolescents With Type 1 Diabetes. Contemporary Clinical Trials, 102(December 2020), 106279. Https://Doi.Org/10.1016/J.Cct.2021.106279
Piloya-Were, T., Nyangabyaki, C., Pappenfus, E., Ahimbisibwe, E., Rwakinanga, E. T., Zhang, L., Bahendeka, S., & Moran, A. (2026). A Study Protocol For A Randomized, Controlled Trial: Improving Glucose Time-In-Range In Diabetes In African Youth (Daytime). Methods And Protocols, 9(2), 1–14. Https://Doi.Org/10.3390/Mps9020043
Purcell, A. R., Rodrigo, N., Longfield, M. S. G., & Glastras, S. J. (2025). Tirzepatide For The Treatment Of Adults Living With Concurrent Type 1 Diabetes And Overweight Or Obesity (TZP-T1D): A Double-Blind, Placebo-Matched Randomised Controlled Trial Protocol. BMJ Open , 15(9), 1–8. Https://Doi.Org/10.1136/Bmjopen-2024-093775
Seo, M., Park, K. H., Park, J. W., Kim, E., Shin, D. Y., Kang, E., Nam, H. K., Rhie, Y. J., & Lee, K. H. (2025). The Role Of Continuous Glucose Monitoring In Improving Glycemic Control In Adolescents With Type 1 Diabetes. Annals Of Pediatric Endocrinology & Metabolism, 30(5), 268. Https://Doi.Org/10.6065/APEM.2550006.003
Shapiro, J. B., Bryant, F. B., Holmbeck, G. N., Hood, K. K., & Weissberg-Benchell, J. (2022). Do Baseline Resilience Profiles Moderate The Effects Of A Resilience-Enhancing Intervention For Adolescents With Type 1 Diabetes? 40(5), 337–346. Https://Doi.Org/10.1037/Hea0001076.Do
Sherr, J. L., Bergford, S., Gal, R. L., Clements, M. A., Patton, S. R., Calhoun, P., Beaulieu, L. C., & Riddell, M. C. (2024). Exploring Factors That Influence Postexercise Glycemia In Youth With Type 1 Diabetes In The Real World: The Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) Study. Diabetes Care, 47(5), 849–857. Https://Doi.Org/10.2337/Dc23-2212
Shumye, M. W., Tegegne, B., Ademe, S., Workneh, M., Abera, M., Nemera, G., & Balcha, F. (2021). The Magnitude Of Diabetes Mellitus In Adult Hypertensive Patients In Northeast Ethiopia. Diabetes, Metabolic Syndrome And Obesity, 14, 37–45. Https://Doi.Org/10.2147/DMSO.S283158
Sinisterra, M., Wang, C. H., Marks, B. E., Barber, J., Tully, C., Monaghan, M., Hilliard, M. E., & Streisand, R. (2021). Patterns Of Continuous Glucose Monitor Use In Young Children Throughout The First 18 Months Following Type 1 Diabetes Diagnosis. 23(11), 777–781. Https://Doi.Org/10.1089/Dia.2021.0183
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C. N., Mbanya, J. C., Pavkov, M. E., Ramachandaran, A., Wild, S. H., James, S., Herman, W. H., Zhang, P., Bommer, C., Kuo, S., Boyko, E. J., & Magliano, D. J. (2022). IDF Diabetes Atlas: Global, Regional And Country-Level Diabetes Prevalence Estimates For 2021 And Projections For 2045. Diabetes Research And Clinical Practice, 183. Https://Doi.Org/10.1016/J.Diabres.2021.109119
Tilden, D. R., French, B., Datye, K. A., & Jaser, S. S. (2024). Disparities In Continuous Glucose Monitor Use Between Children With Type 1 Diabetes Living In Urban And Rural Areas. Diabetes Care, 47(3), 346–352. Https://Doi.Org/10.2337/Dc23-1564
Waibel, M., Thomas, H. E., Wentworth, J. M., Couper, J. J., Macisaac, R. J., Cameron, F. J., So, M., Krishnamurthy, B., Doyle, M. C., & Kay, T. W. (2022). Investigating The Efficacy Of Baricitinib In New Onset Type 1 Diabetes Mellitus (BANDIT)—Study Protocol For A Phase 2, Randomized, Placebo Controlled Trial. Trials, 23(1), 1–12. Https://Doi.Org/10.1186/S13063-022-06356-Z
Ying, L., Zhang, Y., Yin, J., Wang, Y., Lu, W., Zhu, W., Bao, Y., & Zhou, J. (2021). Classic Type 1 Diabetes Mellitus And Fulminant Type 1 Diabetes Mellitus: Similarity And Discrepancy Of Immunological Characteristics And Cytokine Profile. Diabetes, Metabolic Syndrome And Obesity, 14, 4661–4670. Https://Doi.Org/10.2147/DMSO.S334712
Zhou, Y., Wheeler, B. J., Boucsein, A., Styles, S. E., Chamberlain, B., Michaels, V. R., Crockett, H. R., Lala, A., Cunningham, V., Wiltshire, E. J., Serlachius, A. S., & Jefferies, C. (2025). Use Of Freestyle Libre 2.0 In Children with Type 1 Diabetes Mellitus and Elevated Hba1c: Extension Phase Results After A 12-Week Randomized Controlled Trial. Diabetic Medicine, 42(5), 1–9. Https://Doi.Org/10.1111/Dme.15494
Bisio, A., Anderson, S., Norlander, L., O’malley, G., Robic, J., Ogyaadu, S., Hsu, L., Levister, C., Ekhlaspour, L., Lam, D. W., Levy, C., Buckingham, B., & Breton, M. D. (2022). Impact Of A Novel Diabetes Support System on A Cohort of Individuals with Type 1 Diabetes Treated With Multiple Daily Injections: A Multicenter Randomized Study. Diabetes Care, 45(1), 186–193. Https://Doi.Org/10.2337/Dc21-0838
Chan, J., Jackson, N., Rebollar, A. G., Santana, C., De La Garza, G. P., Moin, T., Yee, J. K., & Everett, E. (2025). Association Between Self-Monitored Blood Glucose And Continuous Glucose Monitoring In Youth With Type 1 Diabetes And Medicaid Insurance. Diabetes Care, 48(4), 632–638. Https://Doi.Org/10.2337/Dc24-2224
Crossen, S. S., Romero, C. C., Lewis, C., & Glaser, N. S. (2023). Remote Glucose Monitoring Is Feasible For Patients And Providers Using A Commercially Available Population Health Platform. February, 1–8. Https://Doi.Org/10.3389/Fendo.2023.1063290
Datye, K. A., Tilden, D. R., Parmar, A. M., Goethals, E. R., & Jaser, S. S. (2021). Advances, Challenges, And Cost Associated With Continuous Glucose Monitor Use In Adolescents And Young Adults With Type 1 Diabetes. Current Diabetes Reports, 21(7), 22. Https://Doi.Org/10.1007/S11892-021-01389-1
Deshpande, S., Weinzimer, S. A., Gibbons, K., Nally, L. M., Weyman, K., Carria, L., Zgorski, M., Laffel, L. M., Iii, F. J. D., & Dassau, E. (2024). Feasibility And Preliminary Safety Of Smartphone-Based Automated Insulin Delivery In Adolescents And Children With Type 1 Diabetes. Https://Doi.Org/10.1177/19322968221116384
Elbarbary, N., Moser, O., Al Yaarubi, S., Alsaffar, H., Al Shaikh, A., Ajjan, R. A., & Deeb, A. (2021). Use Of Continuous Glucose Monitoring Trend Arrows In The Younger Population With Type 1 Diabetes. Diabetes & Vascular Disease Research, 18(6). Https://Doi.Org/10.1177/14791641211062155
Jalilova, A., Pilan, B. Ş., Demir, G., Özbaran, B., Balkı, H. G., Arslan, E., Köse, S. G., Özen, S., Darcan, Ş., & Gökşen, D. (2024). The Psychosocial Outcomes Of Advanced Hybrid Closed-Loop System In Children And Adolescents With Type 1 Diabetes. European Journal Of Pediatrics, 183(7), 3095–3103. Https://Doi.Org/10.1007/S00431-024-05551-1
Kartolo, A., Kassouf, W., & Vera-Badillo, F. E. (2021). Adjuvant Immune Checkpoint Inhibition In Muscle-Invasive Bladder Cancer: Is It Ready For Prime Time? European Urology, 80(6), 679–681. Https://Doi.Org/10.1016/J.Eururo.2021.07.019
Kidie, A. A., Lakew, A. M., & Ayele, T. (2021). Frequency Of Diabetic Ketoacidosis And Its Determinants Among Pediatric Diabetes Mellitus Patients In Northwest Ethiopia. Diabetes, Metabolic Syndrome And Obesity, 14, 4819–4827. Https://Doi.Org/10.2147/DMSO.S326537
Levy, C. J., Kudva, Y. C., Ozaslan, B., Castorino, K., O’malley, G., Kaur, R. J., Levister, C. M., Church, M. M., Desjardins, D., Mccrady-Spitzer, S., Ogyaadu, S., Trinidad, M. C., Reid, C., Rizvi, S., Deshpande, S., Zaniletti, I., Kremers, W. K., Pinsker, J. E., Doyle, F. J., & Dassau, E. (2023). At-Home Use Of A Pregnancy-Specific Zone-MPC Closed-Loop System For Pregnancies Complicated By Type 1 Diabetes: A Single-Arm, Observational Multicenter Study. Diabetes Care, 46(7), 1425–1431. Https://Doi.Org/10.2337/Dc23-0173
Madrigal, M. A., López, M., Sánchez, A., Cao, M. J., Castro, M. J., & Jiménez, J. M. (2020). Type 1 Diabetes Mellitus In Pediatric Patients And Its Impact On Relationships In The Family Environment. Diabetes, Metabolic Syndrome And Obesity, 13, 4973–4980. Https://Doi.Org/10.2147/DMSO.S281949
Muthoni L., K. (2025). The Impact Of Continuous Glucose Monitoring (CGM) Versus Self-Monitoring Of Blood Glucose (SMBG) On Glycemic Control In Adults With Type 2 Diabetes. RESEARCH INVENTION JOURNAL OF RESEARCH IN MEDICAL SCIENCES, 4(1), 1–5. Https://Doi.Org/10.59298/RIJRMS/2025/4115
O’Donnell, H. K., Vigers, T., Johnson, S. B., Pyle, L., Wright, N., Deeb, L. C., & Driscoll, K. A. (2021). Pump It Up! A Randomized Clinical Trial To Optimize Insulin Pump Self-Management Behaviors In Adolescents With Type 1 Diabetes. Contemporary Clinical Trials, 102(December 2020), 106279. Https://Doi.Org/10.1016/J.Cct.2021.106279
Piloya-Were, T., Nyangabyaki, C., Pappenfus, E., Ahimbisibwe, E., Rwakinanga, E. T., Zhang, L., Bahendeka, S., & Moran, A. (2026). A Study Protocol For A Randomized, Controlled Trial: Improving Glucose Time-In-Range In Diabetes In African Youth (Daytime). Methods And Protocols, 9(2), 1–14. Https://Doi.Org/10.3390/Mps9020043
Purcell, A. R., Rodrigo, N., Longfield, M. S. G., & Glastras, S. J. (2025). Tirzepatide For The Treatment Of Adults Living With Concurrent Type 1 Diabetes And Overweight Or Obesity (TZP-T1D): A Double-Blind, Placebo-Matched Randomised Controlled Trial Protocol. BMJ Open , 15(9), 1–8. Https://Doi.Org/10.1136/Bmjopen-2024-093775
Seo, M., Park, K. H., Park, J. W., Kim, E., Shin, D. Y., Kang, E., Nam, H. K., Rhie, Y. J., & Lee, K. H. (2025). The Role Of Continuous Glucose Monitoring In Improving Glycemic Control In Adolescents With Type 1 Diabetes. Annals Of Pediatric Endocrinology & Metabolism, 30(5), 268. Https://Doi.Org/10.6065/APEM.2550006.003
Shapiro, J. B., Bryant, F. B., Holmbeck, G. N., Hood, K. K., & Weissberg-Benchell, J. (2022). Do Baseline Resilience Profiles Moderate The Effects Of A Resilience-Enhancing Intervention For Adolescents With Type 1 Diabetes? 40(5), 337–346. Https://Doi.Org/10.1037/Hea0001076.Do
Sherr, J. L., Bergford, S., Gal, R. L., Clements, M. A., Patton, S. R., Calhoun, P., Beaulieu, L. C., & Riddell, M. C. (2024). Exploring Factors That Influence Postexercise Glycemia In Youth With Type 1 Diabetes In The Real World: The Type 1 Diabetes Exercise Initiative Pediatric (T1DEXIP) Study. Diabetes Care, 47(5), 849–857. Https://Doi.Org/10.2337/Dc23-2212
Shumye, M. W., Tegegne, B., Ademe, S., Workneh, M., Abera, M., Nemera, G., & Balcha, F. (2021). The Magnitude Of Diabetes Mellitus In Adult Hypertensive Patients In Northeast Ethiopia. Diabetes, Metabolic Syndrome And Obesity, 14, 37–45. Https://Doi.Org/10.2147/DMSO.S283158
Sinisterra, M., Wang, C. H., Marks, B. E., Barber, J., Tully, C., Monaghan, M., Hilliard, M. E., & Streisand, R. (2021). Patterns Of Continuous Glucose Monitor Use In Young Children Throughout The First 18 Months Following Type 1 Diabetes Diagnosis. 23(11), 777–781. Https://Doi.Org/10.1089/Dia.2021.0183
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B. B., Stein, C., Basit, A., Chan, J. C. N., Mbanya, J. C., Pavkov, M. E., Ramachandaran, A., Wild, S. H., James, S., Herman, W. H., Zhang, P., Bommer, C., Kuo, S., Boyko, E. J., & Magliano, D. J. (2022). IDF Diabetes Atlas: Global, Regional And Country-Level Diabetes Prevalence Estimates For 2021 And Projections For 2045. Diabetes Research And Clinical Practice, 183. Https://Doi.Org/10.1016/J.Diabres.2021.109119
Tilden, D. R., French, B., Datye, K. A., & Jaser, S. S. (2024). Disparities In Continuous Glucose Monitor Use Between Children With Type 1 Diabetes Living In Urban And Rural Areas. Diabetes Care, 47(3), 346–352. Https://Doi.Org/10.2337/Dc23-1564
Waibel, M., Thomas, H. E., Wentworth, J. M., Couper, J. J., Macisaac, R. J., Cameron, F. J., So, M., Krishnamurthy, B., Doyle, M. C., & Kay, T. W. (2022). Investigating The Efficacy Of Baricitinib In New Onset Type 1 Diabetes Mellitus (BANDIT)—Study Protocol For A Phase 2, Randomized, Placebo Controlled Trial. Trials, 23(1), 1–12. Https://Doi.Org/10.1186/S13063-022-06356-Z
Ying, L., Zhang, Y., Yin, J., Wang, Y., Lu, W., Zhu, W., Bao, Y., & Zhou, J. (2021). Classic Type 1 Diabetes Mellitus And Fulminant Type 1 Diabetes Mellitus: Similarity And Discrepancy Of Immunological Characteristics And Cytokine Profile. Diabetes, Metabolic Syndrome And Obesity, 14, 4661–4670. Https://Doi.Org/10.2147/DMSO.S334712
Zhou, Y., Wheeler, B. J., Boucsein, A., Styles, S. E., Chamberlain, B., Michaels, V. R., Crockett, H. R., Lala, A., Cunningham, V., Wiltshire, E. J., Serlachius, A. S., & Jefferies, C. (2025). Use Of Freestyle Libre 2.0 In Children with Type 1 Diabetes Mellitus and Elevated Hba1c: Extension Phase Results After A 12-Week Randomized Controlled Trial. Diabetic Medicine, 42(5), 1–9. Https://Doi.Org/10.1111/Dme.15494
Published
2026-09-30
How to Cite
Machmudy, N., Pratiwi, I., Suarilah, I., Rachmawati, P., & Febriyanti, R. (2026). Continuous Glucose Monitoring versus Self-Monitoring of Blood Glucose for Glycemic Control in Adolescents with Type 1 Diabetes: A Systematic Review. ancasakti ournal f ublic ealth cience nd esearch, 6(3), 246-260. https://doi.org/10.47650/pjphsr.v6i3.2843
Section
Articles
Copyright (c) 2026 Nurur Rachman Machmudy, Ika Nur Pratiwi, Ira Suarilah, Praba Diyan Rachmawati, Rofiqa Dwi Febriyanti
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
1.png)
