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  • Sensor-augmented insulin pump more effective than multiple daily insulin injections for reducing HbA1C in people with poorly controlled type 1 diabetes

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Therapeutics
Randomised controlled trial
Sensor-augmented insulin pump more effective than multiple daily insulin injections for reducing HbA1C in people with poorly controlled type 1 diabetes
  1. Jeroen Hermanides,
  2. J Hans DeVries
  1. Academic Medical Centre, The Netherlands
  1. Correspondence to Jeroen Hermanides
    Department of Anesthesiology, Academic Medical Centre, Amsterdam, The Netherlands; J.Hermanides{at}amc.uva.nl

https://doi.org/10.1136/ebm1159

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    Commentary on:

    1. Bergenstal RM,
    2. Tamborlane WV,
    3. Ahmann A,
    4. et al
    .; STAR 3 Study Group. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes. N Engl J Med 2010;363:311–20.
    OpenUrlCrossRefPubMed

    Context

    With developing technologies, continuous subcutaneous insulin infusion systems (CSII) and continuous subcutaneous glucose monitors (CGM) have become available to treat diabetes mellitus (DM). The effectiveness of CSII to lower HbA1c has been shown, especially in poorly regulated patients with type 1 DM.1 More recent trials investigated the application of CGM in type 1 DM and proved that CGM is effective in lowering HbA1c, again especially in poorly regulated adult patients, provided that they were compliant and tolerated the device.2 Now the two devices have been integrated, augmenting the insulin pump with the sensor. The efficacy of this new treatment platform was investigated.

    Methods

    This was an unblinded randomised controlled trial, performed in 30 diabetes centres throughout the USA and Canada, comparing the efficacy of 1-year sensor-augmented pump therapy (Minimed Paradigm REAL-time system; Medtronic, Northridge, CA.) to multiple daily insulin injection therapy in 485 patients with type 1 DM. Eligible patients were aged 7–70 years old, were on multiple daily injection therapy for at least 3 months prior to inclusion and had HbA1c between 7.4% and 9.5%. Patients who had used insulin pump therapy within 3 years prior to the …

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    Footnotes

    • Competing interests JH has no competing interests. JHDV has given advice and presentations on request to Abbott Diabetes Care and Medtronic and his department has received research support from Abbott Diabetes Care, Dexcom Inc. and Medtronic.