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Getting ‘pumped’ aids kids’ diabetes control

Medicine@Yale, 2010 - July Aug


In type 1 diabetes, autoimmune damage to insulin-producing cells in the pancreas causes abnormally high levels of glucose in the blood. Unchecked, diabetes can cause blindness, kidney failure, and heart disease.

To keep harmful hyperglycemia at bay, patients rely on dietary adjustments and injections of insulin. But successfully managing blood sugar using current methods of self-testing and multiple daily insulin injections is difficult. In adults, continuous glucose monitoring technology and insulin pumps have each proven to better control blood sugar, but these approaches have not worked as well in children.

In a year-long, randomized, multicenter trial known as STAR 3, led at the School of Medicine by William V. Tamborlane, M.D., professor of pediatrics and chief of that department’s Section of Pediatric Endocrinology and Diabetes, sensor-augmented insulin pumps, which combine insulin infusion with continuous glucose monitoring, better controlled blood sugar in type 1 diabetics of all ages than did daily insulin injections. The study, published on June 29 in the online edition of The New England Journal of Medicine, is the first to show consistent results in children.