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ECU Notes, diabetes 

Brody School of Medicine diabetes educator Savanna Martin checks blood-sugar level data with patient Joseph White. White is a member of a research trial that looked at the effectiveness of a new type of insulin pump with a sensor that can help adults and children with diabetes better manage their blood-sugar levels. (Photo by Cliff Hollis)


Study shows sensor helps achieve better glucose control than daily insulin injections

By Doug Boyd

A new type of insulin pump with a sensor can help adults and children with diabetes better manage their blood-sugar levels, according to research conducted at 30 trial sites, including ECU.

The significant decrease in A1C levels observed in the study, called STAR 3, for Sensor-Augmented Pump Therapy for A1C Reduction, occurred without an increase in the rate of hypoglycemia, or low glucose.

A1C testing is a way to measure blood-glucose levels. In people with poorly controlled diabetes, A1C levels are much higher than in healthy people. The study compared use of the sensor-augmented pump to the traditional method of multiple daily insulin injections.

Dr. Robert Tanenberg, a professor and diabetes specialist at the Brody School of Medicine at ECU and a principal investigator of the trial, said the sensor measures tissue glucose levels every five minutes and protects patients from having their blood-sugar levels dropping without them knowing it. That compares to patients who must prick their fingers to measure blood-sugar levels several times a day.

“If you had a sensor, you could probably carry on your life pretty easily,” Tanenberg said. “The beauty of the sensor is it monitors blood sugar and shows a trend.” Eleven ECU diabetes patients were enrolled in the 18-month study.

Joe White, a probation officer from Pinetops, was one patient. He enrolled in the study after a camping trip in which he woke in a sweat then passed out from low blood sugar. Fortunately, his 8-year-old son was heard him rummaging for clothes before passing out. White was taken to a hospital.

“I wasn’t a big fan of the pump,” he said. “I was just used to taking injections and felt I was doing OK with that.”

Adult participants saw a 1 percent point reduction in their A1C levels. Every percentage-point drop in A1C blood test results can reduce the risk of complications by 40 percent. Uncontrolled glucose levels in patients with diabetes can lead to short- and long-term complications, including shakiness, confusion, fainting, blindness, kidney failure, limb amputation and, in rare cases, death.

Among children, nearly 44 percent of patients using sensor-augmented insulin pump therapy achieved age-specific glucose control targets, compared to only 20 percent of patients in the multiple daily injection group.

The study 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. The mean A1C decrease was to 7.5 percent in the sensor-augmented pump therapy group, compared to only 8.1 percent in the daily injection group.  

Pumps have been used for years by some diabetes patients, but until recently they did not have sensors and required finger-sticks to measure glucose levels. Tanenberg hopes the study results will help convince insurance companies to fund these devices for patients with type 1 diabetes.

Study results were presented June 29 at the American Diabetes Association meeting in Orlando, Fla. The study was sponsored by the medical device maker Medtronic and conducted at sites in the United States and Canada with participation from 485 patients ranging in age from 7 to 70.   

This story appeared originally in the Aug. 27, 2010 issue of Pieces of Eight. An archived version of that issue is available at http://www.ecu.edu/cs-admin/news/poe/2010/810/August-2010-Archives.cfm.