IMPROVING METABOLIC CONTROL AND REDUCING HYPOGLYCEMIC RISK IN TYPE 1 DM

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这是一项为期5年的现场结果研究，将调查智能反馈系统在自然环境中帮助1型糖尿病(T1 DM)患者的临床效用。拟议的综合生物行为监测和反馈(IBMF)系统将把血糖自我监测(SMBG)与行为监测和反馈结合起来，并将分为两个层次： 1.IBMF-1将使用SMBG数据估计患者的HbA1c、严重低血糖的急性风险和严重低血糖的慢性风险，并向患者提供这些生物参数的反馈。 2.IBMF-2将增加IBMF-1对低血糖和高血糖症状以及自我治疗行为的监测，将评估特殊症状的重要性和对低血糖的认识，并将向患者提供这些行为参数的反馈。120名患有T1糖尿病的成年人将参与这项研究，为期约1年。 我们假设： IBMF-1将： 1.降低患者发生低血糖的风险(通过基于SMBG的低血糖指数(LBGI)量化)，而不影响他们的糖化血红蛋白(HbA1c)；2.减少患者对低血糖的恐惧(通过对低血糖的恐惧程度来量化)；3.减少严重低血糖的发生。4.改善患者在70至180 mg/dl的血糖目标范围内花费的时间百分比。 IBMF-2将得到改进： 1.对低血糖的认识和对低血糖症状的认识； 2.BG估计的总体精度(用误差网格分析和精度指数量化)； 3.自我治疗行为； 4.BG稳定性。 IBMF 1+2不会导致更高的HbA1c或更高的高血糖风险(由高血糖指数(HBGI)衡量)。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a 5-year field outcomes study that will investigate the clinical utility of an intelligent feedback system assisting patients with type 1 diabetes (T1DM) in their natural environment. The proposed Integrated Biobehavioral Monitoring and Feedback (IBMF) system will integrate self-monitoring of blood glucose (SMBG) with behavioral monitoring and feedback, and will have two levels: 1. IBMF-1 will use SMBG data to estimate patients' HbA1c, acute risk for severe hypoglycemia and chronic risk for severe hypoglycemia, and will provide feedback of these biological parameters to patients. 2. IBMF-2 will add to IBMF-1 monitoring of symptoms of hypoglycemia and hyperglycemia and self-treatment behavior, will assess idiosyncratic symptom significance and hypoglycemia awareness, and will provide feedback of these behavioral parameters to patients. One hundred and twenty adults with T1DM will participate in the study for approximately 1 year. We hypothesize that: IBMF-1 will: 1.Reduce patients' risk of hypoglycemia (quantified by the SMBG-based Low BG Index, LBGI), without compromising their HbA1c; 2.Reduce patients' fear of hypoglycemia (quantified by the Fear of Hypoglycemia Scale); 3.Reduce the occurrence of severe hypoglycemia. 4. Improve the % of time patients spend within the BG target range of 70 to 180 mg/dl. IBMF-2 will improve: 1. hypoglycemia awareness and recognition of hypoglycemic symptoms; 2. overall accuracy in BG estimation (quantified by Error-Grid Analysis and Accuracy Index); 3. Self-treatment behaviors; and 4. BG stability. IBMF 1+2 will not result in higher HbA1c or higher risk for hyperglycemia (measured by the High BG Index, HBGI).