Randomized controlled clinical trial of Blood Glucose Awareness Training (BGAT III) in Switzerland and Germany.
Although both diabetes and the efficacy of medical management are international issues, psycho-educational interventions might be culturally bound. Blood Glucose Awareness Training (BGAT) is a psycho-educational program for patients with type 1 diabetes mellitus. It is focused on improving recognition and management of extreme blood glucose levels, and is the best documented American psycho-educational program for this purpose. A randomized controlled clinical trial of BGAT's long-term benefits in a non-American setting has been lacking. One hundred and eleven adults with type 1 diabetes mellitus from Switzerland and Germany participated. After a 6 months baseline assessment, subjects were randomly assigned to receive either 2 months of BGAT (n = 56) or a physician-guided self-help control intervention (n = 55). BGAT improved recognition of low (p = 0.008), high (p = .03), and overall blood glucose (p = 0.001), and reduced frequency of severe hypoglycemia (p = 0.04), without compromising metabolic control. BGAT reduced both the external locus of control (p < 0.02) and fear of hypoglycemia (p < 0.02). BGAT was efficacious in reducing adverse clinical events and achieving clinically desirable goals in a European, as well as American setting.
Schachinger
Hartmut
H
Department of Clinical Physiology, FB I-Psychobiology, University of Trier, Trier, Germany. schaechi@uni-trier.de
Hegar
Karin
K
Hermanns
Norbert
N
Straumann
Madeleine
M
Keller
Ulrich
U
Fehm-Wolfsdorf
Gabriele
G
Berger
Willi
W
Cox
Daniel
D
D000704:Analysis of Variance; D001364:Awareness; D015190:Blood Glucose Self-Monitoring / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology*; D005239:Fear; D005260:Female; D005858:Germany; D006801:Humans; D007003:Hypoglycemia / Q000517:prevention & control / Q000523:psychology; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D013557:Switzerland