Cyndrome

Sensor-augmented insulin pump therapy achieves significantly better glycemic control in patients with Type 1 diabetes than multiple insulin injections, show results from the STAR 3 study.

The Sensor-Augmented Pump Therapy for A1C Reduction (STAR) 3 study was set up to evaluate the use of a continuous glucose monitor combined with a glucose pump, compared with standard injection therapy in 485 Type 1 diabetics (329 adults, 156 children) with poor glycemic control over a period of 1 year.

Richard Bergenstal (International Diabetes Center at Park Nicollet, Minneapolis, Minnesota, USA) and team report that at study completion, mean glycated hemoglobin (HbA1c) – 8.3% in both groups at baseline – had decreased significantly to 7.5% in the insulin pump group versus 8.1% in the multiple injections group.

In addition, 27% of patients in the insulin pump group achieved their target HbA1c of below 7% compared with only 10% of the multiple injection group.

Rates of severe hypoglycemia were similar in both groups at 13.31 and 13.48 cases per 100 person-years, respectively, in the insulin pump and multiple injection groups. No significant weight gain was observed in either group.

In an accompanying editorial, Howard Wolpert (Joslin Diabetes Center, Boston, Massachusetts, USA) commented: “The STAR 3 study and other randomized trials have shown that continuous glucose monitoring can take the management of Type 1 diabetes to a new level: improved glycemic control without an associated increase in hypoglycemia.”

He said: “The focus now has to move on to translating this evidence into effective practice so that the broader population of patients with Type 1 diabetes can realize these benefits.”

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