Research Article

The effect of an education programme (HyPOS) to treat hypoglycaemia problems in patients with type 1 diabetes

  1. N. Hermanns1,*,
  2. B. Kulzer1,
  3. T. Kubiak1,2,
  4. M. Krichbaum1,
  5. T. Haak1

Article first published online: 23 JAN 2007

DOI: 10.1002/dmrr.710

Issue

Diabetes/Metabolism Research and Reviews

Diabetes/Metabolism Research and Reviews

Volume 23, Issue 7, pages 528–538, October 2007

Additional Information

How to Cite

Hermanns, N., Kulzer, B., Kubiak, T., Krichbaum, M. and Haak, T. (2007), The effect of an education programme (HyPOS) to treat hypoglycaemia problems in patients with type 1 diabetes. Diabetes/Metabolism Research and Reviews, 23: 528–538. doi: 10.1002/dmrr.710

Author Information

  1. 1

    Research Institute of the Diabetes Academy Mergentheim, Germany

  2. 2

    Institute of Psychology, University of Greifswald, Germany

*Forshungsinstitut der Diabetes–Akademie Mergentheim, Postfach 1144, FIDAM, D-97961 Bad Mergentheim, Germany.

Publication History

  1. Issue published online: 21 SEP 2007
  2. Article first published online: 23 JAN 2007
  3. Manuscript Accepted: 9 OCT 2006
  4. Manuscript Revised: 4 OCT 2006
  5. Manuscript Received: 13 APR 2006

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Keywords:

  • hypoglycaemia unawareness;
  • impaired hypoglycaemia awareness;
  • diabetes education;
  • self-management;
  • treatment of hypoglycaemia problems

Abstract

Background

In a randomized, prospective multi-centre trial, the effect of a specific training programme (HyPOS) for patients with hypoglycaemia problems was compared with a control group (CG), receiving a standardized education programme aiming at avoidance of hypoglycaemia by optimization of insulin therapy.

Methods

A total of 164 type 1 diabetes patients (age 46.0 ± 12.5 yrs, HbA1c 7.3 ± 1.0%, 50% male) were randomized. Hypoglycaemia awareness was measured by the hypoglycaemia awareness questionnaire (HAQ) and by a visual analogue scale (VAS). There were no baseline differences.

Results

After a 6-month follow-up, hypoglycaemia awareness significantly improved in HyPOS compared to that in the CG (Δ HAQ 0.7 [95% CL 0.1–1.2], p = 0.024, Δ VAS 0.8 [95% CL 0.2–1.2], p = 0.015). In HyPOS, the threshold for detection of low blood glucose (Δ 0.2 mmol/L [95% CL 0.03–0.04], p = 0.02) and the treatment of low blood glucose (Δ 4.6 g [95% CL 1.6–7.6], p = 0.03) increased significantly. The number of undetected hypogylcaemic episodes (Δ− 1.4 episodes per week [95% CL 0.4–2.5], p = 0.01) and the rate of mild hypoglycaemia dropped significantly in HyPOS (Δ 2.1% [95% CL 0.5–5.3], p = 0.015). The numbers of severe (Δ 0.3 events per patient per year [95% CL − 0.04–1.0], p = 0.037) and very severe hypoglycaemic episodes (Δ 0.3 events per patient per year [95% CL − 0.1–0.7], p = 0.09) were lower in HyPOS, but these differences were not significant.

Conclusion

Compared to the CG, HyPOS demonstrates additional benefits in terms of improving impaired hypoglycaemia awareness, reducing mild hypoglycaemia, detecting low blood glucose, and treating low blood glucose. Copyright © 2007 John Wiley & Sons, Ltd.

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