Continuous monitoring improves blood sugar control

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A year-long clinical trial by Yale University and other institutions showed that treatment with sensor-augmented insulin pumps, which include a system of continuous glucose monitoring, leads to significantly greater control of type 1 diabetes than a daily regimen of multiple insulin injections. Results of the STAR 3 trial were presented at the annual meeting of the American Diabetes Association, and appear online in the New England Journal of Medicine.

The multicenter, randomized and controlled trial compared the efficacy of both methods in 485 adult and child patients. At one year, average plasma glucose concentrations – which indicate blood sugar control in type 1 diabetes – were significantly lower for both adults and children in the pump-therapy group, compared with the injection-therapy group.

Improved glycemic control can reduce the complications associated with type 1 diabetes, but maintaining that control is challenging, particularly for children. “This technology of combining insulin pumps and continuous glucose monitoring can help patients safely reach their goal of glycemic control, while minimizing the risk of severe hypoglycemia and weight gain,” says William Tamborlane, MD, section chief of pediatric endocrinology for Yale Medical Group, a member of the steering committee of the study and second author on the paper.

Recent studies on the effectiveness of using insulin pumps or continuous glucose monitoring devices alone showed that among adults, they improve blood sugar levels better than daily injections. But results in children have been inconsistent. In this new study by Yale and other institutions, sensor-augmented pump therapy, which integrates the two technologies and allows patients and doctors to monitor treatment and response through internet-based software, benefited children as significantly as adults.

“Sensor-augmented pump therapy will be helpful to all patients with type 1 diabetes who were until now unable to effectively control their blood sugar levels, but it will be particularly beneficial for younger patients,” said Jennifer Sherr, MD, who, along with Stuart A. Weinzimer, MD, and Lori Carria, who were the other Yale investigators involved in the study.

The study was supported by Medtronic, Novo Nordisk, LifeScan, Bayer Healthcare and Becton Dickinson. It was also partly funded by the Yale Clinical and Translational Science Award (CTSA) grant from the National Center for Research Resources at the National Institutes of Health.

Tamborlane reports receiving consulting fees from Medtronic Diabetes as a member of the Diabetes Advisory Board.

This Article was submitted by Mark Santore, on Tuesday, January 21, 2014.
Source: Yale Medical Group