BLOOD GLUCOSE AWARENESS TRAINING

胰岛素依赖型糖尿病（IDDM）患者面临的生活- 试图避免高血糖而不引起 低血糖 这就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BG 对这种反馈的估计。 然而，这种估计可能是危险的， 不准确。我们开发的血糖意识培训（BGAT）， 在健康的胰岛素依赖型糖尿病患者中进行测试，有几个直接的好处： 提高准确估计BG的能力，改善代谢控制，以及 减少对低血糖的恐惧。 拟议的项目探讨了 这些影响，并评估方法，以提高BGAT立即和长期- 长期福利。 我们还将评估BGAT对以下患者的益处： 存在增加或未检测到的低血糖风险，包括： 服用β受体阻滞剂，患有视力障碍， 低血糖无意识。 拟议的项目还调查了低血糖对 驾驶和其他日常技能，以及标准的神经心理学 试验. 这些研究的目的之一是确定可靠的自我- 测试表明早期低血糖缺陷。 此外， 将检查低血糖后的驾驶和其他技能。 要执行此操作， 将对40名胰岛素依赖型糖尿病受试者进行不同的测试和驾驶 在各种低血糖水平下进行模拟，以确定对 并评估受试者对这些影响的意识。 信息 从这项研究和其他研究将用于开发一个增强版的 BGAT将用于描述的风险患者组 以上（n=120）。 将评估两个版本的BGAT的效果， 以及强化训练的效果 BGAT后18个月随访 将测试BGAT对能力的短期和长期影响， 估计BG、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.