BLOOD GLUCOSE AWARENESS TRAINING

胰岛素依赖型糖尿病(IDDM)患者将面临 在不引起高血糖的情况下避免高血糖 低血糖症。这需要一个准确和方便的反馈回路 当前血糖(BG)。IDDM患者经常使用主观血糖 对此类反馈的估计。然而，这样的估计可能是危险的。 不准确。血糖意识训练(BGAT)，我们开发和 在健康的IDDM患者中测试，有几个立竿见影的好处： 提高了准确估计血糖的能力，改善了代谢控制，以及 减少了对低血糖的恐惧。拟议的项目探索了这些机制。 并评价了提高BGAT的即刻和长期效果的方法 定期福利。我们还将评估BGAT对以下患者的好处 存在低血糖增加或未被检测到的风险，包括： 服用β受体阻滞剂，视力受损，并报告 没有意识到低血糖。 拟议的项目还调查了低血糖对 驾驶和其他常规技能，以及标准的神经心理学 测试。这些研究的目的之一是确定可靠的自我 显示早期低血糖缺陷的测试。此外，回收 将检查低血糖后的驾驶和其他技能。要做到这点， 40名IDDM受试者将接受不同的测试和驾驶 不同低血糖水平下的模拟，以确定对 表现并评估受试者对这些影响的认识。信息 从这项研究和其他研究将被用来开发增强版本的 BGAT将被实施到所述的高危患者群体 以上(n=120)。将评估两个版本的BGAT的效果，如下所示 以及助推器训练的效果。BGAT后18个月的随访 将提供BGAT对能力的短期和长期影响的测试 评估血糖、代谢控制和低血糖诱导的汽车 事故和住院治疗。

Individuals with Insulin-Dependent Diabetes Mellitus (IDDM) face the life- threatening dilemma of attempting to avoid hyperglycemia without incurring hypoglycemia. This requires an accurate and convenient feedback loop of current blood glucose (BG). IDDM patients frequently use subjective BG estimates for such feedback. However, such estimates can be dangerously inaccurate. Blood Glucose Awareness Training (BGAT), which we developed and tested with healthy IDDM patients, has several immediate benefits: improved ability to accurately estimate BG, improved metabolic control, and reduced fear of hypoglycemia. The proposed project explores the mechanisms of these effects and evaluates methods to enhance BGAT immediate and long- term benefits. We will also assess the benefits of BGAT for patients who are at-risk for increased or undetected hypoglycemia including those: taking beta blockers, suffering visual impairments, and reporting hypoglycemia unawareness. The proposed project also investigates the effects of hypoglycemia on driving and other routine skills, as well as standard neuropsychological tests. One of the purposes of these studies is to identify reliable self- tests that indicate early hypoglycemia deficits. In addition, recovery of driving and other skills after hypoglycemia will be examined. To do this, 40 IDDM subjects will be administered different tests and driving simulations under various levels of hypoglycemia to determine effects on performance and evaluate subjects' awareness of these effects. Information from this and other studies will be used to develop an enhanced version of BGAT that will be administered to the at-risk patient groups described above (n=120). The effects of two versions of BGAT will be evaluated, as well as the effects of booster training. An 18-month post-BGAT followup will provide a test of both short- and long-term effects of BGAT on ability to estimate BG, metabolic control and hypoglycemia-induced automobile accidents and hospitalizations.