Changes in short-term and long-term control of diabetes after participation in blood glucose awareness training
Bellando, Betty Jayne
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Research on insulin dependent diabetes mellitus (IDDM) has demonstrated that the symptoms of hyper- and hypoglycemia are idiosyncratic and stable over time. Patients, however, may attribute erroneous physiological cues as being related to diabetes. This can be dangerous since patients may rely on these cues to alert them to dangerous changes in blood glucose levels. The Blood Glucose Awareness Training course was conducted with adolescents in order to increase their awareness of individual symptoms of hyper- and hypoglycemia, to improve accuracy in estimating blood glucose levels, and to determine this effect on long-term diabetes control. Twenty-two adolescents (11 each in the treatment and control groups) participated in the study. Both groups were evaluated at weeks one, seven, and at a three-month follow-up. At these points subjects were asked to rate 23 blood glucose symptoms presently being experienced, to estimate blood glucose levels, to rate confidence in their ability to identify symptoms of hyper- hypoglycemia, and to self-monitor blood glucose levels. Opinions about IDDM were also assessed. A blood sample was obtained to measure long-term control of diabetes. In addition, subjects in the training group were asked to rate symptoms and estimate blood glucose levels over the seven-week courses. Results replicated other investigatorsâ€™ findings that group analysis does not reveal consistent symptoms of hyper- and hypoglycemia. Individual data analysis revealed idiosyncratic blood glucose symptoms for subjects. Between-group ANOVAS revealed that all subjects were initially accurate in estimating blood glucose levels, and this did not significantly change over the course of the study. There was not significant change in long-term control of diabetes for either group. Both groups significantly decreased their belief in adhering to strict rules to manage their diabetes. There was a trend for treatment subjects to improve their ability to estimate blood glucose levels. Results did indicate that subjects became more accurate at estimating extreme levels of blood glucose. This study supports the perspective that idiosyncratic data is essential in the area of IDDM. It is yet unclear if beneficial change occurred due to training course participation.