Blood glucose awareness training (BGAT-2): long-term benefits.
OBJECTIVE
Blood glucose awareness training (BGAT) has been shown to improve awareness of blood glucose (BG) fluctuations among adults with type 1 diabetes. This study investigates the long-term (12-month) benefits of BGAT-2.


METHODS
A total of 73 adults with type 1 diabetes participated in a 6-month repeated baseline design with a 12-month follow-up. At 6 months and 1 month before BGAT-2 and at 1,6, and 12 months after BGAT-2, subjects used a handheld computer for 50 trials and completed psychological tests. Throughout assessment, subjects completed diaries, recording occurrences of diabetic ketoacidosis, severe hypoglycemia, and motor vehicle violations During follow-up, 50% of the subjects received booster training.


RESULTS
During the first and last halves of both the baseline period and the follow-up period, dependent variables were generally stable. However, from baseline to follow-up, BGAT-2 led to 1) improved detection of hypoglycemia and hyperglycemia; 2) improved judgment regarding when to lower high BG, raise low BG, and not drive while hypoglycemic; 3) reduction in occurrence of diabetic ketoacidosis, severe hypoglycemia, and motor vehicle violations; and 4) improvement in terms of worry about hypoglycemia, quality of life, and diabetes knowledge. Reduction in severe hypoglycemia was not associated with a worsening of metabolic control (HbA1). The presence or absence of booster training did not differentially affect these benefits.


CONCLUSIONS
BGAT has sustained broad-ranging benefits, independent of booster intervention.
Cox
D J
DJ
University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Gonder-Frederick
L
L
Polonsky
W
W
Schlundt
D
D
Kovatchev
B
B
Clarke
W
W
D001007:Anxiety; D001334:Automobile Driving; D001364:Awareness; D001786:Blood Glucose / Q000032:analysis / Q000502:physiology*; D015190:Blood Glucose Self-Monitoring; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D016883:Diabetic Ketoacidosis / Q000517:prevention & control; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000453:epidemiology / Q000517:prevention & control*; D007600:Judgment; D010353:Patient Education as Topic; D011581:Psychological Tests; D013997:Time Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin