Effectiveness of sensor-augmented pump therapy in children and adolescents with type 1 diabetes in the STAR 3 study
Effectiveness of sensor-augmented pump therapy in children and adolescents with type 1 diabetes in the STAR 3 study
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DOI：
10.1111/j.1399-5448.2011.00793.x
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发表时间：
2012-02-01
影响因子：
3.4
通讯作者：
Tamborlane, William V.
中科院分区：
文献类型：
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作者：
Slover, Robert H.;Welsh, John B.;Tamborlane, William V.
Slover RH、威尔士 JB、Criego A、Weinzimer SA、Willi SM、Wood MA、Tamborlane WV。 STAR 3 研究中传感器增强泵疗法对 1 型糖尿病儿童和青少年的有效性。Pediatric Diabetes 2012: 13: 6-11。目的：对于许多 1 型糖尿病儿科患者来说，维持适当的 A1C 值和尽量减少高血糖波动是很困难的。连续血糖监测 (CGM) 传感器增强泵 (SAP) 疗法是该人群每日多次注射 (MDI) 疗法的替代方案。研究设计和方法：用于降低 A1C 的传感器增强泵疗法 (STAR 3) 是一项为期 1 年的试验，纳入了 82 名儿童（7-12 岁）和 74 名青少年（13-18 岁），A1C 值范围为 7.4% 至 9.5%，他们被随机接受 SAP 治疗或 MDI 治疗。从所有受试者中获取季度 A1C 值。在基线、6 个月和 12 个月时进行 CGM 研究，以量化血糖波动[计算为葡萄糖浓度-时间曲线 (AUC) 下的面积]和变异性。在 SAP 组中，记录了传感器依从性。结果：随机分配到 SAP 组 (8.26 +/- 0.55%) 和 MDI 组 (8.30 +/- 0.53%) 的受试者的基线 A1C 值相似。所有随后的 A1C 值均显示治疗组差异显着 (p < 0.05)，有利于 SAP 治疗。与 MDI 组相比，SAP 组的受试者更有可能达到特定年龄的 A1C 目标，并且高血糖的 AUC 值较低，且低血糖风险没有增加。与 MDI 组相比，SAP 组的血糖变异性有所改善。与青少年相比，儿童更频繁地佩戴 CGM 传感器，并且更有可能达到特定年龄的 A1C 目标。结论：SAP 治疗使 1 型糖尿病控制有限或控制不充分的儿童和青少年能够以快速、可持续和安全的方式降低 A1C 值、高血糖偏移和血糖变异性。
Slover RH, Welsh JB, Criego A, Weinzimer SA, Willi SM, Wood MA, Tamborlane WV. Effectiveness of sensor-augmented pump therapy in children and adolescents with type 1 diabetes in the STAR 3 study.Pediatric Diabetes 2012: 13: 6-11.Objective: Maintenance of appropriate A1C values and minimization of hyperglycemic excursions are difficult for many pediatric patients with type 1 diabetes. Continuous glucose monitoring (CGM) sensor-augmented pump (SAP) therapy is an alternative to multiple daily injection (MDI) therapy in this population.Research design and methods: Sensor-augmented pump therapy for A1C reduction (STAR 3) was a 1-yr trial that included 82 children (aged 7-12) and 74 adolescents (aged 13-18) with A1C values ranging from 7.4 to 9.5% who were randomized to either SAP or MDI therapy. Quarterly A1C values were obtained from all subjects. CGM studies were carried out at baseline, 6 months, and 12 months to quantify glycemic excursions [ calculated as area under the glucose concentration-time curve (AUC)] and variability. In the SAP group, sensor compliance was recorded.Results: Baseline A1C values were similar in subjects randomized to the SAP (8.26 +/- 0.55%) and MDI groups (8.30 +/- 0.53%). All subsequent A1C values showed significant (p < 0.05) treatment group differences favoring SAP therapy. Compared with the MDI group, subjects in the SAP group were more likely to meet age-specific A1C targets and had lower AUC values for hyperglycemia with no increased risk of hypoglycemia. Glucose variability improved in the SAP group compared to the MDI group. Children wore CGM sensors more often and were more likely to reach age-specific A1C targets than adolescents.Conclusions: SAP therapy allows both children and adolescents with marginally or inadequately controlled type 1 diabetes to reduce A1C values, hyperglycemic excursions, and glycemic variability in a rapid, sustainable, and safe manner.