Yu Kuei Lin, Wen Ye, Helen Rogers, A. Brooks, Elena Toschi, D. Kariyawasam, Simon R Heller, N. de Zoysa, Stephanie A Amiel
{"title":"减轻先进糖尿病技术用户的严重低血糖症:作为干预目标的低血糖意识受损和无益的低血糖信念。","authors":"Yu Kuei Lin, Wen Ye, Helen Rogers, A. Brooks, Elena Toschi, D. Kariyawasam, Simon R Heller, N. de Zoysa, Stephanie A Amiel","doi":"10.1089/dia.2024.0039","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nA subgroup analysis of the Hypoglycemia Awareness Restoration Programme for people with type 1 diabetes and problematic hypoglycemia (HARPdoc) trial was conducted to explore the impact of Blood Glucose Awareness Training (BGAT, a hypoglycemia awareness training program) and the HARPdoc (a psychoeducation addressing unhelpful hypoglycemia beliefs) in reducing severe hypoglycemia (SH) in individuals using advanced diabetes technologies (ADTs).\n\n\nMETHODS\nData from trial participants who utilized ADTs including continuous glucose monitors or automated insulin delivery systems were extracted. Generalized linear mixed effects models with Poisson distribution or linear mixed effects models were employed to evaluate SH incidence, and Gold questionnaire, Attitudes to Awareness of Hypoglycemia (A2A), Problem Areas in Diabetes (PAID), Hospital Anxiety and Depress Scale (HADS)-anxiety, and HADS-depression scores as measures of hypoglycemia awareness, unhelpful hypoglycemia beliefs, diabetes distress, and anxiety and depression symptoms, respectively.\n\n\nRESULTS\nIn the 45 participants using ADTs, the BGAT and HARPdoc interventions both reduced SH incidence by more than 50% (P<0.0001) and yielded improvements in hypoglycemia awareness (P<0.05). HARPdoc outperformed BGAT in reducing SH at month 24 (P=0.01). HARPdoc also mitigated unhelpful hypoglycemia beliefs (P<0.0001), diabetes distress (P<0.05), and anxiety symptoms (P<0.05); BGAT demonstrated no significant impacts in these respects. Neither HARPdoc nor BGAT had significant effects on depression symptoms.\n\n\nCONCLUSION\nPsychoeducation (BGAT and HARPdoc) was effective in reducing SH in people using ADTs. HARPdoc may also provide greater long-term SH reduction and improves psychological wellbeing in this patient group.","PeriodicalId":11159,"journal":{"name":"Diabetes technology & therapeutics","volume":null,"pages":null},"PeriodicalIF":5.7000,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mitigating Severe Hypoglycemia in Users of Advanced Diabetes Technologies: Impaired Awareness of Hypoglycemia and Unhelpful Hypoglycemia Beliefs as Targets for Interventions.\",\"authors\":\"Yu Kuei Lin, Wen Ye, Helen Rogers, A. Brooks, Elena Toschi, D. Kariyawasam, Simon R Heller, N. de Zoysa, Stephanie A Amiel\",\"doi\":\"10.1089/dia.2024.0039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nA subgroup analysis of the Hypoglycemia Awareness Restoration Programme for people with type 1 diabetes and problematic hypoglycemia (HARPdoc) trial was conducted to explore the impact of Blood Glucose Awareness Training (BGAT, a hypoglycemia awareness training program) and the HARPdoc (a psychoeducation addressing unhelpful hypoglycemia beliefs) in reducing severe hypoglycemia (SH) in individuals using advanced diabetes technologies (ADTs).\\n\\n\\nMETHODS\\nData from trial participants who utilized ADTs including continuous glucose monitors or automated insulin delivery systems were extracted. Generalized linear mixed effects models with Poisson distribution or linear mixed effects models were employed to evaluate SH incidence, and Gold questionnaire, Attitudes to Awareness of Hypoglycemia (A2A), Problem Areas in Diabetes (PAID), Hospital Anxiety and Depress Scale (HADS)-anxiety, and HADS-depression scores as measures of hypoglycemia awareness, unhelpful hypoglycemia beliefs, diabetes distress, and anxiety and depression symptoms, respectively.\\n\\n\\nRESULTS\\nIn the 45 participants using ADTs, the BGAT and HARPdoc interventions both reduced SH incidence by more than 50% (P<0.0001) and yielded improvements in hypoglycemia awareness (P<0.05). HARPdoc outperformed BGAT in reducing SH at month 24 (P=0.01). HARPdoc also mitigated unhelpful hypoglycemia beliefs (P<0.0001), diabetes distress (P<0.05), and anxiety symptoms (P<0.05); BGAT demonstrated no significant impacts in these respects. Neither HARPdoc nor BGAT had significant effects on depression symptoms.\\n\\n\\nCONCLUSION\\nPsychoeducation (BGAT and HARPdoc) was effective in reducing SH in people using ADTs. HARPdoc may also provide greater long-term SH reduction and improves psychological wellbeing in this patient group.\",\"PeriodicalId\":11159,\"journal\":{\"name\":\"Diabetes technology & therapeutics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.7000,\"publicationDate\":\"2024-04-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diabetes technology & therapeutics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/dia.2024.0039\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes technology & therapeutics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/dia.2024.0039","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Mitigating Severe Hypoglycemia in Users of Advanced Diabetes Technologies: Impaired Awareness of Hypoglycemia and Unhelpful Hypoglycemia Beliefs as Targets for Interventions.
OBJECTIVE
A subgroup analysis of the Hypoglycemia Awareness Restoration Programme for people with type 1 diabetes and problematic hypoglycemia (HARPdoc) trial was conducted to explore the impact of Blood Glucose Awareness Training (BGAT, a hypoglycemia awareness training program) and the HARPdoc (a psychoeducation addressing unhelpful hypoglycemia beliefs) in reducing severe hypoglycemia (SH) in individuals using advanced diabetes technologies (ADTs).
METHODS
Data from trial participants who utilized ADTs including continuous glucose monitors or automated insulin delivery systems were extracted. Generalized linear mixed effects models with Poisson distribution or linear mixed effects models were employed to evaluate SH incidence, and Gold questionnaire, Attitudes to Awareness of Hypoglycemia (A2A), Problem Areas in Diabetes (PAID), Hospital Anxiety and Depress Scale (HADS)-anxiety, and HADS-depression scores as measures of hypoglycemia awareness, unhelpful hypoglycemia beliefs, diabetes distress, and anxiety and depression symptoms, respectively.
RESULTS
In the 45 participants using ADTs, the BGAT and HARPdoc interventions both reduced SH incidence by more than 50% (P<0.0001) and yielded improvements in hypoglycemia awareness (P<0.05). HARPdoc outperformed BGAT in reducing SH at month 24 (P=0.01). HARPdoc also mitigated unhelpful hypoglycemia beliefs (P<0.0001), diabetes distress (P<0.05), and anxiety symptoms (P<0.05); BGAT demonstrated no significant impacts in these respects. Neither HARPdoc nor BGAT had significant effects on depression symptoms.
CONCLUSION
Psychoeducation (BGAT and HARPdoc) was effective in reducing SH in people using ADTs. HARPdoc may also provide greater long-term SH reduction and improves psychological wellbeing in this patient group.
期刊介绍:
Diabetes Technology & Therapeutics is the only peer-reviewed journal providing healthcare professionals with information on new devices, drugs, drug delivery systems, and software for managing patients with diabetes. This leading international journal delivers practical information and comprehensive coverage of cutting-edge technologies and therapeutics in the field, and each issue highlights new pharmacological and device developments to optimize patient care.