Journal of Behavioral Medicine

, Volume 28, Issue 6, pp 587–594 | Cite as

Randomized Controlled Clinical Trial of Blood Glucose Awareness Training (BGAT III) in Switzerland and Germany

  • Hartmut Schachinger
  • Karin Hegar
  • Norbert Hermanns
  • Madeleine Straumann
  • Ulrich Keller
  • Gabriele Fehm-Wolfsdorf
  • Willi Berger
  • Daniel Cox

Although both diabetes and the efficacy of medical management are international issues, psycho-educational interventions might be culturally bound. Blood Glucose Awareness Training (BGAT) is a psycho-educational program for patients with type 1 diabetes mellitus. It is focused on improving recognition and management of extreme blood glucose levels, and is the best documented American psycho-educational program for this purpose. A randomized controlled clinical trial of BGAT's long-term benefits in a non-American setting has been lacking. One hundred and eleven adults with type 1 diabetes mellitus from Switzerland and Germany participated. After a 6 months baseline assessment, subjects were randomly assigned to receive either 2 months of BGAT (n = 56) or a physician-guided self-help control intervention (n = 55). BGAT improved recognition of low (p = 0.008), high (p = .03), and overall blood glucose (p = 0.001), and reduced frequency of severe hypoglycemia (p = 0.04), without compromising metabolic control. BGAT reduced both the external locus of control (p < 0.02) and fear of hypoglycemia (p < 0.02). BGAT was efficacious in reducing adverse clinical events and achieving clinically desirable goals in a European, as well as American setting.


blood glucose awareness training severe hypoglycemia psycho-educational program clinical trial hypoglycemia fear 



Blood Glucose Awareness Training




1–6 months after intervention


7–12 months after intervention



This study was supported by the Swiss National Diabetes Foundation (SDG), Basel Diabetes Foundation (DGRBB), Walter-und Margarethe von Lichtenstein Foundation, Freie Akademische Gesellschaft Basel, Lilly Inc., Switzerland, and Astra-Fonds. We thank Prof. Dr. Wolf Langewitz and Dr. Brigitta Wössmer, who helped with clinical supervision and advice. We also thank the following diabetes nurses, who were actively engaged in motivating and referring patients: Cornelia Müller, Vreni Bättig, Regula Schinz, Marco Pavan (all Basel) and Bettina Blaser (Luzern).


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Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • Hartmut Schachinger
    • 1
    • 2
  • Karin Hegar
    • 2
    • 3
  • Norbert Hermanns
    • 4
  • Madeleine Straumann
    • 5
  • Ulrich Keller
    • 3
  • Gabriele Fehm-Wolfsdorf
    • 6
  • Willi Berger
    • 3
  • Daniel Cox
    • 7
  1. 1.Department of Clinical PhysiologyFB I—Psychobiology, University of TrierTrierGermany
  2. 2.Psychosomatic MedicineDepartment of Internal Medicine, University HospitalBaselSwitzerland
  3. 3.Endocrinology, Diabetology and Clinical NutritionDepartment of Internal Medicine, University HospitalBaselSwitzerland
  4. 4.Diabetes CenterBad MergentheimGermany
  5. 5.Diabetes Outpatient ClinicOltenSwitzerland
  6. 6.Lübeck Institute of Behavioral MedicineLübeckGermany
  7. 7.Center for Behavioral Medicine ResearchDepartment of Psychiatric Medicine, University of VirginiaCharlottesvilleUSA

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