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Effectiveness of Sensor-Augmented Insulin-Pump Therapy in Type 1 Diabetes
Open accessAbstract
BACKGROUND: Recently developed technologies for the treatment of type 1 diabetes mellitus include a variety of pumps and pumps with glucose sensors. METHODS: In this 1-year, multicenter, randomized, controlled trial, we compared the efficacy of sensor-augmented pump therapy (pump therapy) with that of a regimen of multiple daily insulin injections (injection therapy) in 485 patients (329 adults and 156 children) with inadequately controlled type 1 diabetes. Patients received recombinant insulin analogues and were supervised by expert clinical teams. The primary end point was the change from the baseline glycated hemoglobin level. RESULTS: At 1 year, the baseline mean glycated hemoglobin level (8.3% in the two study groups) had decreased to 7.5% in the pump-therapy group, as compared with 8.1% in the injection-therapy group (P<0.001). The proportion of patients who reached the glycated hemoglobin target (<7%) was greater in the pump-therapy group than in the injection-therapy group. The rate of severe hypoglycemia in the pump-therapy group (13.31 cases per 100 person-years) did not differ significantly from that in the injection-therapy group (13.48 per 100 person-years, P=0.58). There was no significant weight gain in either group. CONCLUSIONS: In both adults and children with inadequately controlled type 1 diabetes, sensor-augmented pump therapy resulted in significant improvement in glycated hemoglobin levels, as compared with injection therapy. A significantly greater proportion of both adults and children in the pump-therapy group than in the injection-therapy group reached the target glycated hemoglobin level. (Funded by Medtronic and others; ClinicalTrials.gov number, NCT00417989.)
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“A trial comparing a sensor-augmented pump with multiple daily injection therapy showed significant improvement in HbA1C reduction with less hypoglycaemia in the sensor-augmented pump cohort.88,94”
From Type 1 diabetes (2014) · cites this paper as [88]
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“A randomised controlled trial in adults with type 1 diabetes reported lower HbA1C concentrations with sensor-augmented pump therapy than with injection therapy, and a greater proportion of patients reaching the targeted levels of HbA1C.88”
From Type 1 diabetes (2014) · cites this paper as [88]
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“The use of rtCGM sensors has proved to be very beneficial for glycemic control [10,16,17].”
From Advanced Diabetes Management Using Artificial Intelligence and Continuous Glucose Monitoring Sensors (2020) · cites this paper as [16]
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Metadata
- Authors
- Bergenstal, R. M., Tamborlane, W. V., Ahmann, A., Buse, J. B., Dailey, G., Davis, S. N., Joyce, C., Peoples, T., Perkins, B. A., Welsh, J. B., Willi, S. M., & Wood, M. A.
- Affiliations
- Park Nicollet Health Services (US)
- Yale University (US)
- Oregon Health & Science University (US)
- University of North Carolina at Chapel Hill (US)
- University of Maryland, Baltimore (US)
- Memorial University of Newfoundland (CA)
- Toronto General Hospital (CA)
- Children's Hospital of Philadelphia (US)
- Helen DeVos Children's Hospital (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2010-07-22
- Volume
- 363
- Issue
- 4
- Pages
- 311-320
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2142433802
- Cited by
- 894
- References
- 12
- Citations by year
- 2026: 18 · 2025: 25 · 2024: 38 · 2023: 28 · 2022: 41 · 2021: 50 · 2020: 43 · 2019: 55 · 2018: 66 · 2017: 62 · 2016: 71 · 2015: 78 · 2014: 63 · 2013: 65 · 2012: 88
- FWCI
- 61.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK079637)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 1 diabetes, sensor-augmented insulin pump therapy, multiple daily insulin injections, HbA1c, glycemic control, hypoglycemia, insulin analogues, children and adults, weight gain
- MeSH terms
- Adolescent, Adult, Analysis of Variance, Child, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Male, Middle Aged, Diabetic Ketoacidosis, Treatment Outcome, Monitoring, Ambulatory, Young Adult
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