LONG-TERM FOLLOW-UP EVALUATION AT BLOOD-GLUCOSE AWARENESS TRAINING

OBJECTIVE- Blood glucose awareness training (BGAT) has been found effe ctive in teaching individuals with insulin-requiring diabetes to impro ve their ability to better recognize blood glucose (BG) fluctuations. This study investigated whether subjects who underwent BGAT a mean of 4.9 years previously were superior to past control subjects in terms o f their ability to recognize BG fluctuations, and whether past BGAT su bjects had fewer automobile crashes and lost work days and better glyc osylated hemoglobin than control subjects. Additionally, the beneficia l effects of providing booster training to past BGAT subjects also was evaluated. RESEARCH DESIGN AND METHODS- This study followed up 28 pas t BGAT subjects. Half of these subjects (n = 14) received a simple boo ster-training program. Twelve previous control subjects also were eval uated. Booster subjects were given a BGAT diary to complete for 2 week s before evaluation. Evaluation for all subjects included completion o f a retrospective questionnaire on work and driving history, blood dra wing for a glycosylated hemoglobin analysis, and having subjects estim ate and measure their BG levels 50-80 times during a 3- to 4-week peri od during their daily routine. RESULTS- At long-term follow-up, BGAT s ubjects had significantly fewer automobile crashes than control subjec ts. BGAT subjects receiving booster training were significantly more a ccurate at estimating their BG levels and were more aware of hypoglyce mia. Post hoc analyses indicated that the ability to accurately estima te BG fluctuations correlated positively with follow-up glycosylated h emoglobin and the number of hypoglycemic and hyperglycemic symptoms pa rticipants demonstrated. Both BGAT and control subjects demonstrated s ignificantly improved glycosylated hemoglobin relative to baseline mea sures. CONCLUSIONS- These data suggest that BGAT has long-term benefit s, which can be enhanced with booster training. Specifically, BGAT and simple booster training may result in reduction of severe hypoglycemi c episodes and automobile crashes in the long term.