Portal de investigação
Changes in attitudes to awareness of hypoglycaemia during a hypoglycaemia awareness restoration programme are associated with avoidance of further severe hypoglycaemia episodes within 24 months: the A2A in HypoCOMPaSS study
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Sepúlveda, E
- Jacob, P
- Poínhos, R
- Vicente, SG
- Smith, EL
- Shaw, JAM
- Speight, J
- Choudhary, P
- de Zoysa, N
- Amiel, SA
- HypoCOMPaSS Study Grp
Unidades de investigação
Abstract
Aims/hypothesis The aims of this study were to assess cognitions relating to hypoglycaemia in adults with type 1 diabetes and impaired awareness of hypoglycaemia before and after the multimodal HypoCOMPaSS intervention, and to determine cognitive predictors of incomplete response (one or more severe hypoglycaemic episodes over 24 months). Methods This analysis included 91 adults with type 1 diabetes and impaired awareness of hypoglycaemia who completed the Attitudes to Awareness of Hypoglycaemia (A2A) questionnaire before, 24 weeks and 24 months after the intervention, which comprised a short psycho-educational programme with optimisation of insulin therapy and glucose monitoring. Results The age and diabetes duration of the participants were 48 +/- 12 and 29 +/- 12 years, respectively (mean +/- SD). At baseline, 91% reported one or more severe hypoglycaemic episodes over the preceding 12 months; this decreased to < 20% at 24 weeks and after 24 months (p=0.001). The attitudinal barrier 'hyperglycaemia avoidance prioritised' (eta(2)(p)=0.250, p=0.001) decreased from baseline to 24 weeks, and this decrease was maintained at 24 months (mean +/- SD=5.3 +/- 0.3 vs 4.3 +/- 0.3 vs 4.0 +/- 0.3). The decrease in 'asymptomatic hypoglycaemia normalised' from baseline (eta(2)(p)=0.113, p=0.045) was significant at 24 weeks (1.5 +/- 0.3 vs 0.8 +/- 0.2). Predictors of incomplete hypoglycaemia response (one or more further episodes of severe hypoglycaemia) were higher baseline rates of severe hypoglycaemia, higher baseline scores for 'asymptomatic hypoglycaemia normalised', reduced change in 'asymptomatic hypoglycaemia normalised' scores at 24 weeks, and lower baseline 'hypoglycaemia concern minimised' scores (all p < 0.05). Conclusions/interpretation Participation in the HypoCOMPaSS RCT was associated with improvements in hypoglycaemia-associated cognitions, with 'hyperglycaemia avoidance prioritised' most prevalent. Incomplete prevention of subsequent severe hypoglycaemia episodes was associated with persistence of the cognition 'asymptomatic hypoglycaemia normalised'. Understanding and addressing cognitive barriers to hypoglycaemia avoidance is important in individuals prone to severe hypoglycaemia episodes. [GRAPHICS] .
Dados da publicação
- ISSN/ISSNe:
- 0012-186X, 1432-0428
- Tipo:
- Article
- Páginas:
- 631-641
- Link para outro recurso:
- www.scopus.com
Diabetologia Springer Verlag
Citações Recebidas na Web of Science: 5
Citações Recebidas na Scopus: 8
Documentos
- Não há documentos
Filiações
Keywords
- Hypoglycaemia; Impaired awareness of hypoglycaemia; Type 1 diabetes
Financiamento
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Citar a publicação
Sepúlveda E,Jacob P,Poínhos R,Carvalho D,Vicente SG,Smith EL,Shaw J,Speight J,Choudhary P,de Zoysa N,Amiel SA,HypoCOMPaSS GRP. Changes in attitudes to awareness of hypoglycaemia during a hypoglycaemia awareness restoration programme are associated with avoidance of further severe hypoglycaemia episodes within 24 months: the A2A in HypoCOMPaSS study. Diabetologia. 2023. 66. (4):p. 631-641. IF:8,200. (1).
