Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Broers, Sandra; Cessie, Saskia le; Vliet, K.P. van; Spinhoven, Ph.; Ven, Nicole C. W. van der; Radder, J.K.

doi:10.1046/j.1464-5491.2002.00682.x

Cited by 29 publications

(44 citation statements)

References 14 publications

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“…Broers et al 11 hypothesized that BGAT administered individually would be more effective than when delivered in the traditional group format. There was no difference between individually and groupadministered BGAT- 19 demonstrated that the Dutch BGAT-1 significantly improved recognition of hypoglycemic episodes, improved decisions not to drive during hypoglycemia, improved decisions to raise low blood glucose, and significantly reduced both the occurrence of severe hypoglycemic episodes and vehicular collisions.…”

Section: Blood Glucose Awareness Trainingmentioning

confidence: 99%

“…Unit 8 summarizes what has been learned from the previous 7 weeks of training and promotes relapse prevention. The manual for the second version of BGAT (BGAT-2) is written in English and has also been translated into German, 10 Dutch, 11 and Japanese. The first randomized clinical trial by Cox et al 13 investigated whether the first version of BGAT-1 improved accuracy of blood glucose estimates.…”

Section: Blood Glucose Awareness Trainingmentioning

confidence: 99%

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Blood Glucose Awareness Training: What Is It, Where Is It, and Where Is It Going?

Cox¹,

Gönder-Frederick²,

Ritterband³

et al. 2006

Diabetes Spectrum

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Management of type 1 diabetes requires a continual balancing of insulin,fuel intake, and metabolic demand (e.g., exercise). This can only be accomplished with knowledge of where one's blood glucose is and where it is going and knowledge of how to manipulate insulin, fuel, and exercise to manage it. Blood Glucose Awareness Training (BGAT) is a psychoeducational intervention that in part addresses these needs. Fifteen research studies from the United States and Europe, involving single-site and multicenter projects,are reviewed. BGAT has been consistently demonstrated to improve the ability to detect and diminish both hypoglycemia and hyperglycemia while reducing the sequelae of extreme blood glucose levels (e.g., episodes of severe hypoglycemia and driving mishaps). BGAT has recently been transformed for internet delivery, making it available both for clinicians to use with their patients and for individuals with type 1 diabetes to pursue as a self-directed tutorial.

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Section: Blood Glucose Awareness Trainingmentioning

confidence: 99%

Section: Blood Glucose Awareness Trainingmentioning

confidence: 99%

Blood Glucose Awareness Training: What Is It, Where Is It, and Where Is It Going?

Cox¹,

Gönder-Frederick²,

Ritterband³

et al. 2006

Diabetes Spectrum

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“…43 Since then, BGAT, has undergone revision and adapted for use in various countries, showing sustained benefits in reducing SH rates, and improving hypoglycemia awareness through the ability to detect low BG values, without affecting glycemic control. 44,45 BGAT functions on the premise that systematic feedback provides the information needed to make adjustments in diabetes management to improve self-regulation. BGAT can be delivered through the internet, as another way of using technology to reduce hypoglycemia.…”

Section: Better Predictionmentioning

confidence: 99%

Technology to Reduce Hypoglycemia

Yeoh

Choudhary

2015

J Diabetes Sci Technol

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Hypoglycemia remains a major limiting factor toward the intensification of treatment for diabetes mellitus 1 and is a major cost to patients and to health care systems. 2 Hypoglycemia is often divided into mild or nonsevere hypoglycemia episodes (NSHE), where the person is able to selftreat, and severe hypoglycemia (SH), where external assistance is required. It is difficult to set a biochemical threshold for hypoglycemia, as the glucose threshold at which symptoms of hypoglycemia can be detected vary between individuals and even from day to day within the same person.3 The ADA workgroup on hypoglycemia offers some consensus guidelines, defining an alert value of ≤70 mg/dl, measured through self-monitored blood glucose (SMBG) or subcutaneous continuous glucose monitoring (CGM), as indicative of the potential for developing hypoglycemia. 4 All those treated with insulin secretagogues (sulphonylureas, glinides) and insulin therapy are at risk of hypoglycemia, and this risk is increased in the presence of endogenous insulin deficiency, longer duration of diabetes and longer duration of insulin therapy.5 Epidemiological data suggest that people with type 1 diabetes (T1D) with optimal glycemic control experience up to 2 mild episodes/week, with 20-30% experiencing episodes severe enough to require external help in any given year.6 A small proportion of these people, usually with impaired awareness of hypoglycemia, contribute to more than half of the incidence of SH, having recurrent disabling and sometimes life threatening events. 7CGM studies designed to study normative data suggest that while hypoglycemia is common in all insulin-treated people with diabetes, compared to subjects with type 2 diabetes (T2D), T1D subjects had twice as many hypoglycemic episodes per day, with more hours per day in the hypoglycemic range.8 However, although the incidence per patient of NSHE and SH is lower in T2D, due to the greater prevalence of T2D, the majority of episodes of SH occur in people with T2D. 9 In the US, rates of admissions for hypoglycemia have increased in recent years to 105 admissions per 100 000 person-years. 10 Antecedent hypoglycemia has been shown to blunt symptom and counter-regulatory hormonal responses to subsequent hypoglycemia.11 Over time, recurrent hypoglycemia eventually leads to a reduction in the ability to detect hypoglycemia and mount a hormonal response to it, known as impaired awareness of hypoglycemia (IAH) which can increase the risk of SH 6-fold. 12 In the T1D Exchange clinic registry, ≥ 1 SH events occurred in ~6% of over 9000 participants within 12 months, and was not associated with baseline glycated hemoglobin (HbA1c) levels. 13 Undoubtedly, SH has substantial clinical consequences on morbidity (both physical and psychological) and mortality. The more subtle effects of SH and hypoglycemia unawareness are often AbstractHypoglycemia is a major barrier toward achieving glycemic targets and is associated with significant morbidity (both psychological and physical) and mortality. This article re...

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“…The device has been successfully used by health professionals when documenting patient data and using printed data in decision making [5,6,7], telementoring surgical procedures [8], securing patients' identity at blood sampling and transfusion procedures [9], following patients' blood glucose level [10], measuring rapidly and easily blood pressure, pulse rate, temperature, and oxygen saturation via health monitoring sensors connected to the handheld computer [11], and in counselling patients about their symptoms [12]. Hand-held computers have also been used to document clinical and educational activities and in medical student education, daily training, clinical practice and research [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Occupational Risk Identification Using Hand-Held or Laptop Computers

Naumanen

Savolainen

Liesivuori

2008

International Journal of Occupational Safety and Ergonomics

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This paper describes the Work Environment Profile (WEP) program and its use in risk identification by computer. It is installed into a hand-held computer or a laptop to be used in risk identification during work site visits. A 5-category system is used to describe the identified risks in 7 groups, i.e., accidents, biological and physical hazards, ergonomic and psychosocial load, chemicals, and information technology hazards. Each group contains several qualifying factors. These 5 categories are colour-coded at this stage to aid with visualization. Risk identification produces visual summary images the interpretation of which is facilitated by colours. The WEP program is a tool for risk assessment which is easy to learn and to use both by experts and nonprofessionals. It is especially well adapted to be used both in small and in larger enterprises. Considerable time is saved as no paper notes are needed.risk identification assessment work site visit hand-held computer laptop print-outs

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Blood Glucose Awareness Training in Dutch Type 1 diabetes patients. Short‐term evaluation of individual and group training

Abstract: The effects of BGAT were smaller than expected. Possible reasons for this negative outcome may be the adapted version of BGAT (shorter in duration), a lack of statistical power, or a difference between American and European samples in their reaction to BGAT.

Cited by 29 publications

References 14 publications

Blood Glucose Awareness Training: What Is It, Where Is It, and Where Is It Going?

Blood Glucose Awareness Training: What Is It, Where Is It, and Where Is It Going?

Technology to Reduce Hypoglycemia

Occupational Risk Identification Using Hand-Held or Laptop Computers

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