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Original Articles

A Multicenter Evaluation of Blood Glucose Awareness Training-II

  1. Daniel Cox, PHD,
  2. Linda Gonder-Frederick, PHD,
  3. William Polonsky, PHD,
  4. David Schlundt, PHD,
  5. Diana Julian, MA and
  6. William Clarke, MD
  1. University of Virginia Health Sciences Center Charlottesville, Virginia
  2. Joslin Diabetes Center Boston, Massachusetts
  3. Vanderbilt University Medical School Nashville, Tennessee
  1. Address correspondence and reprint requests to Daniel J. Cox, MD, Box 223, University of Virginia Health Sciences Center, Charlottesville, VA 22908.
Diabetes Care 1995 Apr; 18(4): 523-528. https://doi.org/10.2337/diacare.18.4.523
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Abstract

OBJECTIVE Blood glucose awareness training (BGAT) teaches individuals with insulin-dependent diabetes to more accurately estimate/detect their blood glucose (BG) fluctuations. It has not, however, consistently resulted in improved ability to detect low BG. To assess an enhanced version of BGAT (BGAT-II), with more focus on increasing sensitivity to low BG events, a multicenter study was undertaken. Following up on previous findings that BGAT is most effective with individuals who are least accurate in estimating BG, this study explicitly recruited subjects who did and did not report reduced awareness of hypoglycemia.

RESEARCH DESIGN AND METHODS Seventy-eight subjects from three research sites participated in a repeated baseline design. Subjects' BG estimation accuracy and BG profiles were assessed 6 months before, immediately before, and immediately after BGAT-II.

RESULTS Post-treatment, BGAT-II led to better overall accuracy in detecting BG fluctuations and better detection of both low and high BG levels. This was achieved while the number of low readings of self-monitoring of blood glucose (SMBG) was reduced. Reduction in the number of low SMBG events was significant only for subjects reporting awareness of hypoglycemia. Detection of low BG was significant only for subjects reporting reduced awareness of hypoglycemia. Both groups demonstrated equivalent improvements in detection of high BG levels.

CONCLUSIONS BGAT may be an effective behavioral strategy for reversing hypoglycemic unawareness and an adjunct to intensive insulin therapy to reduce the occurrence of severe hypoglycemia.

  • Received July 7, 1994.
  • Revision received December 22, 1994.
  • Accepted December 22, 1994.
  • Copyright © 1995 by the American Diabetes Association

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April 1995, 18(4)
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A Multicenter Evaluation of Blood Glucose Awareness Training-II
Daniel Cox, Linda Gonder-Frederick, William Polonsky, David Schlundt, Diana Julian, William Clarke
Diabetes Care Apr 1995, 18 (4) 523-528; DOI: 10.2337/diacare.18.4.523

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A Multicenter Evaluation of Blood Glucose Awareness Training-II
Daniel Cox, Linda Gonder-Frederick, William Polonsky, David Schlundt, Diana Julian, William Clarke
Diabetes Care Apr 1995, 18 (4) 523-528; DOI: 10.2337/diacare.18.4.523
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