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Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) Study

Published:2011-10-15 Issue:11 Volume:34 Page:2403-2405
ISSN:0149-5992
Container-title:Diabetes Care
language:en
Short-container-title:

Author:

Bergenstal Richard M.¹,Tamborlane William V.²,Ahmann Andrew³,Buse John B.⁴,Dailey George⁵,Davis Stephen N.⁶,Joyce Carol⁷,Perkins Bruce A.⁸,Welsh John B.⁹,Willi Steven M.¹⁰,Wood Michael A.¹¹,

Affiliation:

1. International Diabetes Center at Park Nicollet, Minneapolis, Minnesota

2. Yale Center for Clinical Investigation, Yale School of Medicine, New Haven, Connecticut

3. Harold Schnitzer Diabetes Health Center, Oregon Health and Science University, Portland, Oregon

4. Department of Medicine, Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill, North Carolina

5. Division of Diabetes and Endocrinology, Scripps Clinic and Research Foundation, La Jolla, California

6. Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland

7. Department of Medicine, Memorial University of Newfoundland, St. John’s Health Science Centre, St. Johns’s, Newfoundland and Labrador, Canada

8. Department of Medicine, Division of Endocrinology, University of Toronto School of Medicine, Toronto, Ontario, Canada

9. Medtronic, Inc., Northridge, California

10. Diabetes Center for Children, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

11. Division of Pediatric Endocrinology, Helen DeVos Children’s Hospital, Grand Rapids, Michigan

Abstract

OBJECTIVE To examine the effects of crossing over from optimized multiple daily injection (MDI) therapy to sensor-augmented pump (SAP) therapy for 6 months, and the effects of 18 months’ sustained use of SAP. RESEARCH DESIGN AND METHODS The 6-month, single-crossover continuation phase of Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) provided SAP therapy to 420 subjects who completed the 1-year randomized study. The primary outcome was change in A1C in the crossover group. RESULTS A1C values were initially lower in the continuing-SAP group than in the crossover group (7.4 vs. 8.0%, P < 0.001). A1C values remained reduced in the SAP group. After 3 months on the SAP system, A1C decreased to 7.6% in the crossover group (P < 0.001); this was a significant and sustained decrease among both adults and children (P < 0.05). CONCLUSIONS Switching from optimized MDI to SAP therapy allowed for rapid and safe A1C reductions. Glycemic benefits of SAP therapy persist for at least 18 months.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

Link

https://diabetesjournals.org/care/article-pdf/34/11/2403/607055/2403.pdf

Reference7 articles.

1. STAR 3 randomized controlled trial to compare sensor-augmented insulin pump therapy with multiple daily injections in the treatment of type 1 diabetes: research design, methods, and baseline characteristics of enrolled subjects;Davis;Diabetes Technol Ther,2010

2. Effectiveness of sensor-augmented insulin-pump therapy in type 1 diabetes;Bergenstal;N Engl J Med,2010

3. Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia;American Diabetes Association Workgroup on Hypoglycemia;Diabetes Care,2005

4. Incremental value of continuous glucose monitoring when starting pump therapy in patients with poorly controlled type 1 diabetes: the RealTrend study;Raccah;Diabetes Care,2009

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