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

Abstract

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.

Structured type 1 diabetes education delivered in routine care in Australia reduces diabetes-related emergencies and severe diabetes-related distress: The OzDAFNE program

“…Thus, OzDAFNE offers an important clinical intervention in Australia, particularly given the absence of psycho-educational programs specifically targeting prevention of severe hypoglycaemia, e.g. blood glucose awareness training [18].…”

Diabetes: Psychosocial Aspects

“…Possible reasons not to treat hypoglycemia include underestimation of the individual risk of severe hypoglycemia, poor interoception, fear of diabetes complications, or situational factors complicating a timely treatment. Treatment approaches to IHA comprise the rigorous avoidance of hypoglycemic episodes to reverse the adaptational processes that led to lower thresholds for hypoglycemic symptoms, educational programs consisting of symptom perception training such as the blood glucose awareness training (BGAT, Cox et al, 2006), or more empowerment-based approaches with a focus on personal goal-setting, self-management, and coping skills to prevent and treat hypoglycemia (HyPOS, Hermanns et al, 2010).…”

Self-regulation theory and self-monitoring of blood glucose behavior in type 2 diabetes mellitus.

“…While individuals may consider physiological sensation to be a reliable and important form of feedback in illness, people are often mistaken about the actual meaning of internal sensations or the lack thereof. Blood glucose awareness is the main target of a successful intervention related to SMBG in adults with type 1 diabetes, Blood Glucose Awareness Training (BGAT; Cox et al, 2006). This training is aimed at improving a patients' ability to regulate their blood glucose levels by way of an intervention that exposes them to the sensations they do, or do not, experience at different blood sugar levels.…”

“…This training is aimed at improving a patients' ability to regulate their blood glucose levels by way of an intervention that exposes them to the sensations they do, or do not, experience at different blood sugar levels. The intervention has been shown to improve blood glucose estimates and recognition of dangerous hypoglycemic and hyperglycemic episodes (Cox et al, 2006).…”