Fear of hypoglycaemia is the most commonly reported anxiety for people with type 1 diabetes and their relatives. This, coupled with hypoglycaemia unawareness, is a major cause of distress and anxiety for people with type 1 and can lead individuals to maintain elevated blood glucose levels.
Blood glucose awareness training (BGAT) is a educational program designed to improve the accuracy of patients’ detection and interpretation of relevant blood glucose symptoms and other cues. Thirteen U.S. and European studies have documented the benefits of BGAT, which include improvements in accuracy of blood glucose estimates, reduction in ketoacidosis, severe hypoglycemia, hypoglycemia-related driving mishaps and fear of hypoglycemia.
A team from the Combined Universities Centre for Rural Health (CUCRH) and DiabetesWA received permission from the original BGAThome developers to adapt, trial and evaluate the program for the Australian market under the name BGAThomeWA.
BGAThomeWA was trialled with 35 participants aged from 22 to 77 who have been diagnosed with type 1 diabetes for between two and 55 years. Pre and post trial questionnaires and psychological well-being tests were conducted to measure the program’s effectiveness.
Trial participants reported the following benefits as a result of completing BGAThomeWA:
- Improved understanding of diabetes;
- Increased acceptance of diabetes;
- Improved awareness of when BGLs are likely to be high or low;
- Increased understanding of what to do to avoid BGLs going too high or too low;
- Increased understanding of what to do when BGLs are too high or too low; and
- Feeling in greater control of diabetes.
Results of the psychological well-being testing showed reductions in two key measures - diabetes specific distress and worry about hypoglycemia.
The BGAThomeWA Project Team concluded that the program shows promise for supporting people with type 1 diabetes, particularly those living in rural and remote areas that do not have ready access specialist diabetes care and education. However further work is required to improve usability and performance of the BGAThomeWA website before it is ready to roll-out.