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© 2001 by the American Diabetes Association, Inc.
Clinical Care/Education/Nutrition |
Blood Glucose Awareness Training (BGAT-2)
Long-term benefits
1 University of Virginia Health Sciences Center, Charlottesville, Virginia
2 Joslin Diabetes Center, Boston
3 the Psychology Department, Vanderbilt University
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.
RESEARCH DESIGN AND 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.
CONCLUSION—BGAT has sustained broad-ranging benefits, independent of booster intervention.
Abbreviations: ANOVA, analysis of variance • BDI, Beck Depression Inventory • BG, blood glucose • BGAT, blood glucose awareness training • DKA, diabetic ketoacidosis • EGA, Error Grid Analysis • MANOVA, multiple analysis of variance • SMBG, self-monitoring of blood glucose
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