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

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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.

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Abbreviations

BGAT:

Blood Glucose Awareness Training

T0:

baseline

T1:

1–6 months after intervention

T2:

7–12 months after intervention

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ACKNOWLEDGMENTS

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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Authors and Affiliations

  1. Department of Clinical Physiology, FB I—Psychobiology, University of Trier, Trier, Germany

    Hartmut Schachinger

  2. Psychosomatic Medicine, Department of Internal Medicine, University Hospital, Basel, Switzerland

    Hartmut Schachinger & Karin Hegar

  3. Endocrinology, Diabetology and Clinical Nutrition, Department of Internal Medicine, University Hospital, Basel, Switzerland

    Karin Hegar, Ulrich Keller & Willi Berger

  4. Diabetes Center, Bad Mergentheim, Germany

    Norbert Hermanns

  5. Diabetes Outpatient Clinic, Olten, Switzerland

    Madeleine Straumann

  6. Lübeck Institute of Behavioral Medicine, Lübeck, Germany

    Gabriele Fehm-Wolfsdorf

  7. Center for Behavioral Medicine Research, Department of Psychiatric Medicine, University of Virginia, Charlottesville, Virginia, USA

    Daniel Cox

Authors
  1. Hartmut Schachinger
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  2. Karin Hegar
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  3. Norbert Hermanns
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  4. Madeleine Straumann
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  5. Ulrich Keller
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  6. Gabriele Fehm-Wolfsdorf
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  7. Willi Berger
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  8. Daniel Cox
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Corresponding author

Correspondence to Hartmut Schachinger.

Appendix

Appendix

The following centers participated in the study: Basel University Hospital (HS, KH, WB and UK), diabetes outpatient center practice, Olten (MS), diabetes clinic, Bad Mergentheim (NH), diabetes outpatient center practice, Solothurn (Ernst Iff), diabetes outpatient center practice, Aarau (Jürg Lareida), diabetes outpatient center practice, Winterthur (Elisabeth Nützi), diabetes outpatient center practice, Luzern (Frank Ackermann), and Kantonspital Luzern (Christoph Henzen).

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Schachinger, H., Hegar, K., Hermanns, N. et al. Randomized Controlled Clinical Trial of Blood Glucose Awareness Training (BGAT III) in Switzerland and Germany. J Behav Med 28, 587–594 (2005). https://doi.org/10.1007/s10865-005-9026-3

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