Insulin Pumps Shown to Be Effective For Children and Adolescents with Diabetes

Diabetes research conducted at Helen DeVos Children’s Hospital and 29 other trial sites in the U.S. and Canada showed children and adults with Type 1 diabetes achieved better glucose control by using a sensor-augmented insulin pump compared to the most common approach to care today – multiple daily insulin injections. Results from The Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) trial were recently published online in The New England Journal of Medicine and presented at the American Diabetes Association 70th Scientific Sessions.

The significant decrease in A1C levels observed in STAR 3 occurred without an increase in the rate of hypoglycemia, which is the most prevalent clinical risk with intensive insulin management. Uncontrolled glucose levels in patients with diabetes can lead to short- and long-term complications, including shakiness, confusion, fainting, blindness, kidney failure and limb amputation. Carefully-controlled glucose levels are a goal of diabetes treatment and can improve patient health and long-term outcomes.

STAR 3 is the first study to confirm sensor-augmented insulin pump therapy provides superior glucose control for children and adolescents, an age group that is particularly challenging to treat due to the social and physiological changes related to growth and maturation, said Mike Wood, MD, division chief, pediatric endocrinology, Helen DeVos Children’s Hospital. In STAR 3, nearly 44 percent of pediatric patients using sensor-augmented insulin pump therapy achieved the American Diabetes Association’s age-specific glucose control targets, compared to only 20 percent of patients in the multiple daily injection group.

Every percentage point drop in A1C blood test results can reduce the risk of complications with the eyes or kidneys by 40 percent. Diabetes association guidelines recommend most people with diabetes maintain A1C levels of seven percent or below in order to live healthier and more productive lives.

STAR 3 also showed patients on sensor-augmented insulin pump therapy demonstrated a reduction in mean A1C (levels that was four times greater than the multiple daily injection group (0.8 percent study vs. 0.2 percent control (p<.001). The mean A1C decrease was from a baseline of 8.3 percent to 7.5 percent in the sensor-augmented pump therapy group, compared to only 8.3 percent to 8.1 percent in the daily injection group. The results demonstrated a strong link between increased sensor use and increased benefit. Patients who used the sensor with the insulin pump more than 81 percent of the time reduced their A1C levels by 1.2 percent.

The study was sponsored by Medtronic, Inc. and conducted at 30 sites in the U.S. and Canada with participation from 485 patients (329 adult and 156 pediatric subjects), ranging in age from 7 to 70.

Helen DeVos Children’s Hospital, a member of Spectrum Health, is a Grand Rapids-based hospital serving children throughout Michigan. A teaching hospital, it includes more than 150 pediatric physicians with specialized training in providing medical and surgical care to children in more than 40 pediatric specialties. Visit devoschildrens.org to learn more or devoschildrens.org/2011 to learn about the new hospital opening in 2011.