Thomas MG, Avari P, Godsland IF, et al. - Because a pathway to self-management optimisation begins with the addition of continuous subcutaneous insulin infusion (CSII) or continuous glucose monitoring (CGM) to an intensified multiple-dose injection insulin (MDI) regimen supported by self-monitoring of blood glucose (SMBG) for the vast majority of adults with type 1 diabetes, but there is limited data to support whether CGM or CSII is the optimal first choice on that pathway, researchers sought to guide clinical decision making about which intervention would be the most beneficial as an adjunct to support and education for people with type 1 diabetes who self-manage with intensive insulin therapy. From 1999 to September 2020, electronic databases ie, Medline, Embase and Web of Science were systematically searched. According to this systematic review and meta-analysis, diabetic ketoacidosis was more likely to occur with CSII than with MDI. When combined with MDI and SMBG, both CGM and CSII remain effective interventions. However, in adults with type 1 diabetes and in the contexts studied, CGM may have a greater positive impact on glycaemic variability and severe hypoglycaemia than CSII. To investigate these findings further, a head-to-head study with patient-reported outcomes is required.