title: The effect of an education programme (HyPOS) to treat hypoglycaemia problems in patients with type 1 diabetes.
abstract: BACKGROUND
  In a randomized, prospective multi-centre trial, the effect of a specific training programme (HyPOS) for patients with hypoglycaemia problems was compared with a control group (CG), receiving a standardized education programme aiming at avoidance of hypoglycaemia by optimization of insulin therapy.
  
  
  METHODS
  A total of 164 type 1 diabetes patients (age 46.0 +/- 12.5 yrs, HbA(1c) 7.3 +/- 1.0%, 50% male) were randomized. Hypoglycaemia awareness was measured by the hypoglycaemia awareness questionnaire (HAQ) and by a visual analogue scale (VAS). There were no baseline differences.
  
  
  RESULTS
  After a 6-month follow-up, hypoglycaemia awareness significantly improved in HyPOS compared to that in the CG (Delta HAQ 0.7 [95% CL 0.1-1.2], p = 0.024, Delta VAS 0.8 [95% CL 0.2 - 1.2], p = 0.015). In HyPOS, the threshold for detection of low blood glucose (Delta 0.2 mmol/L [95% CL 0.03 - 0.04], p = 0.02) and the treatment of low blood glucose (Delta 4.6 g [95% CL 1.6 - 7.6], p = 0.03) increased significantly. The number of undetected hypogylcaemic episodes (Delta - 1.4 episodes per week [95% CL 0.4-2.5], p = 0.01) and the rate of mild hypoglycaemia dropped significantly in HyPOS (Delta 2.1% [95% CL 0.5-5.3], p = 0.015). The numbers of severe (Delta 0.3 events per patient per year [95% CL - 0.04-1.0], p = 0.037) and very severe hypoglycaemic episodes (Delta 0.3 events per patient per year [95% CL - 0.1-0.7], p = 0.09) were lower in HyPOS, but these differences were not significant.
  
  
  CONCLUSIONS
  Compared to the CG, HyPOS demonstrates additional benefits in terms of improving impaired hypoglycaemia awareness, reducing mild hypoglycaemia, detecting low blood glucose, and treating low blood glucose.
authors.affiliation: Research Institute of the Diabetes Academy Mergentheim, Germany. hermanns@diabetes-zentrum.de
authors.forename: N
authors.initials: N
authors.lastname: Hermanns
authors.forename: B
authors.initials: B
authors.lastname: Kulzer
authors.forename: T
authors.initials: T
authors.lastname: Kubiak
authors.forename: M
authors.initials: M
authors.lastname: Krichbaum
authors.forename: T
authors.initials: T
authors.lastname: Haak
mesh_terms: D001364:Awareness; D003479:Curriculum; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D007003:Hypoglycemia / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D010353:Patient Education as Topic; D018579:Patient Selection; D011788:Quality of Life
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin