News Article
Hypoglycemia Unawareness Intervention Helps Control Blood Glucose
WASHINGTON (EGMN) - Some diabetes patients are unaware of the signs of hypoglycemia, and teaching them about it can aid in blood glucose control, according to results from a small study.
Hypoglycemia unawareness is thought to occur in 25% of type 1 diabetes patients with long-standing disease, Cheri Ann Hernandez, Ph.D., said at the annual meeting of the American Association of Diabetes Educators.
Dr. Hernandez, of the University of Windsor, Ont., defined self-awareness as:
- Being constantly sensitive to body cues and sensations.
- Knowing one's body's particular cues and signals that result from low, normal, and high blood glucose.
- Understanding the circumstances that might precipitate low, normal, and high blood glucose cues.
- Knowing one's body norms for different times of the day or days of the month - perhaps even seasons of the year.
For their study, Dr. Hernandez, who is a certified diabetes educator, and her colleagues recruited 25 patients who had been designated by their physicians as having hypoglycemia unawareness. A total of 12 were male; the mean age was 51 years (range 24-73 years), and average duration of diabetes was 24 years (range 7-45 years). Two-thirds were married, and two-thirds had attended a college or university. Follow-up was performed at 6, 12, and 18 months.
The intervention, which consisted of a series of eight 3-hour biweekly sessions, included a self-awareness video, small- and large-group discussions, "What's Your Blood Sugar?" exercises, use of a self-awareness manual, review of blood glucose meter use and care by an external consultant, and one extra blood glucose test per day than was previously being performed. The instructors also gave patients home exercises to do; participation in those was voluntary but encouraged.
At 12 months, the researchers found a statistically significant increase in the number of cues that patients recognized for normal blood glucose, but not for high or low blood glucose. At 18 months, patients recognized significantly more cues for both normal and low blood glucose but not for high blood glucose, Dr. Hernandez said. "We're hoping that because they were checking more, they discovered it before it got all that high."
There was also a significant improvement in hemoglobin A
However, the self-awareness intervention did not significantly decrease the number of hypoglycemia-related incidents (such as car accidents or driving infractions) at either 12 or 18 months, Dr. Hernandez noted. "We know that we have a problem there because ... we were relying on memory," and also because the number of participants was so small. "We would have needed larger numbers to get some significance.
"We concluded that participation in a self-awareness intervention does have the potential to increase awareness of body cues and to enhance physical and psychosocial well-being," she said.
The study was funded by the Canadian Diabetes Association. Dr. Hernandez reported no conflicts of interest.
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