Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) Study
Open accessAbstract
OBJECTIVE To examine the effects of crossing over from optimized multiple daily injection (MDI) therapy to sensor-augmented pump (SAP) therapy for 6 months, and the effects of 18 months' sustained use of SAP. RESEARCH DESIGN AND METHODS The 6-month, single-crossover continuation phase of Sensor-Augmented Pump Therapy for A1C Reduction (STAR 3) provided SAP therapy to 420 subjects who completed the 1-year randomized study. The primary outcome was change in A1C in the crossover group. RESULTS A1C values were initially lower in the continuing-SAP group than in the crossover group (7.4 vs. 8.0%, P < 0.001). A1C values remained reduced in the SAP group. After 3 months on the SAP system, A1C decreased to 7.6% in the crossover group (P < 0.001); this was a significant and sustained decrease among both adults and children (P < 0.05). CONCLUSIONS Switching from optimized MDI to SAP therapy allowed for rapid and safe A1C reductions. Glycemic benefits of SAP therapy persist for at least 18 months.
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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.
“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 [94]
The Abstract Conclusions report greater A1C reductions with sensor-augmented pump therapy than with multiple daily injections. The Results do not support the claim of less hypoglycaemia: in the continuation phase, severe hypoglycaemia rates were not significantly different between the continuing-pump and crossover groups. Our copy does not establish a lower hypoglycaemia rate for the pump cohort versus the injection cohort. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA1C fails to identify the magnitude and frequency of intra- and inter-day glucose variation.
“A1C also fails to identify the magnitude and frequency of intra- and inter-day glucose variation (34; 35).”
From Clinical Targets for Continuous Glucose Monitoring Data Interpretation: Recommendations From the International Consensus on Time in Range (2019) · cites this paper as [34]
The Results and Conclusions (page unavailable) report changes in A1C and their association with CGM sensor use. Our copy does not address whether A1C fails to identify the magnitude or frequency of within-day or between-day glucose variation; searches for that phrase and for glucose variability found no such passage. (LLM, conf=0.76)
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- Authors
- Bergenstal, R. M., Tamborlane, W. V., Ahmann, A., Buse, J. B., Dailey, G., Davis, S. N., Joyce, C., Perkins, B. A., Welsh, J. B., Willi, S. M., Wood, M. A., & for the STAR 3 Study Group
- Affiliations
- Park Nicollet Clinic (US)
- Yale University (US)
- Oregon Health & Science University (US)
- University of North Carolina at Chapel Hill (US)
- Scripps Clinic (US)
- University of Maryland, Baltimore (US)
- Memorial University of Newfoundland (CA)
- University of Toronto (CA)
- Medtronic (United States) (US)
- Children's Hospital of Philadelphia (US)
- Spectrum Health (US)
- Corresponding author
- Bergenstal, Richard M.
- ORCID
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-10-15
- Volume
- 34
- Issue
- 11
- Pages
- 2403-2405
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3198292
- OpenAlex
- W2105443410
- Cited by
- 118
- References
- 8
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 12 · 2019: 12 · 2018: 6 · 2017: 12 · 2016: 12 · 2015: 12 · 2014: 8 · 2013: 4 · 2012: 15
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- American Diabetes Association
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Children's Hospital of Philadelphia
- Intarcia Therapeutics
- Insulet Corporation
- MannKind Corporation
- Halozyme
- Dexcom
- ResMed
- UnitedHealth Group
- Bayer HealthCare
- Novo Nordisk
- Memorial University of Newfoundland
- Abbott Diabetes Care
- School of Medicine, University of North Carolina at Chapel Hill
- Daiichi Sankyo Europe
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- sensor-augmented pump therapy, continuous glucose monitoring, insulin pump, multiple daily insulin injections, glycemic control, HbA1c reduction, type 1 diabetes, treatment switching
- MeSH terms
- Adolescent, Adult, Aged, Blood Glucose, Child, Diabetes Mellitus, Type 1, Female, Glycated Hemoglobin, Humans, Hyperglycemia, Hypoglycemic Agents, Injections, Subcutaneous, Insulin, Insulin Infusion Systems, Male, Middle Aged, Treatment Outcome, Cross-Over Studies, Young Adult
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