Intensive versus standard blood glucose awareness training (BGAT) with insulin-dependent diabetes: mechanisms and ancillary effects.
Insulin-dependent diabetes mellitus (IDDM) patients make critical daily self-care decisions on the basis of what they estimate their blood glucose (BG) levels to be. This study: a) replicated efficacy of Standard Blood Glucose Awareness Training (BGAT), b) evaluated the relative efficacy of an Intensive Blood Glucose Awareness Training (BGAT) to enhance patient accuracy of BG estimation, and c) evaluated the mechanisms and ancillary effects of BGAT. Thirty-nine subjects were randomly assigned to one of three groups. Compared with Control, both Standard and Intensive BGAT improved accuracy (p less than 0.001). Intensive BGAT post-treatment accuracy relative to Standard BGAT did not reach statistical significance (p = 0.177). Greater improvement in accuracy was associated with poorer pretreatment accuracy. Only Intensive BGAT improved metabolic control (glycosylated hemoglobin), and this improvement was associated with poorer pretreatment control. The effects of BGAT were highly specific, affecting only accuracy and metabolic control, and not affecting fear of hypoglycemia, diabetes knowledge, of frequency of blood glucose monitoring.
Cox
D J
DJ
University of Virginia Health Sciences Center, Charlottesville 22901.
Gonder-Frederick
L
L
Julian
D
D
Cryer
P
P
Lee
J H
JH
Richards
F E
FE
Clarke
W
W
D000328:Adult; D001364:Awareness; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D010353:Patient Education as Topic; D012803:Sick Role
D006442:Glycated Hemoglobin; D007328:Insulin