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International Journal of Behavioral Medicine

, Volume 11, Issue 4, pp 212–218 | Cite as

Hypoglycemia anticipation, awareness and treatment training (HAATT) reduces occurrence of severe hypoglycemia among adults with type 1 diabetes mellitus

  • Daniel J. CoxEmail author
  • Boris Kovatchev
  • Boris Kovatchev
  • Dragomir Koev
  • Lidia Koeva
  • Svetoslav Dachev
  • Dimitar Tcharaktchiev
  • Anastassia Protopopova
  • Linda Gonder-Frederick
  • William Clarke
Article

Abstract

Severe hypoglycemia (SH) can be a significant problem for patients around the world with Type 1 Diabetes Mellitus (T1DM). To avoid SH, patients need to better manage, and reduce the occurrence of, preceding mild hypoglycemia. Hypoglycemia Anticipation, Awareness and Treatment Training (HAATT), developed in the United States specifically to address such issues, was evaluated at short- and long-term follow-up in a medically, economically and culturally different setting; Bulgaria. Sixty adults with T1DM and a history of recurrent SH (20 each from Sofia, Russe, and Varna, Bulgaria) were randomized to Self-Monitoring of Blood Glucose (SMBG) or SMBG+ HAATT. For 6 months before and 1 to 6 and 13 to 18 months after intervention, participants recorded occurrence of moderate, severe, and nocturnal hypoglycemia. For 1-month pre- and post-intervention, participants completed daily diaries concerning their diabetes management. Relative to SMBG, HAATT produced significant improvement in occurrence of low BG, moderate, severe, and nocturnal hypoglycemia, and detection and treatment of low BG (p values < .05 to < .001), with no compromise in metabolic control. At long-term follow-up, HAATT participants continued to have significantly fewer episodes of moderate and severe hypoglycemia. These findings suggest that a structured, specialized psycho-educational treatment program (HAATT) can be highly effective in managing hypoglycemia.

Key words

severe hypoglycemia HAATT self-monitoring of blood glucose (SMBG) Type 1 Diabetes Mellitus (T1DM) Blood Glucose Awareness Training (BGAT) 

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Copyright information

© International Society of Behavioral Medicine 2004

Authors and Affiliations

  • Daniel J. Cox
    • 1
    • 5
    Email author
  • Boris Kovatchev
    • 1
  • Boris Kovatchev
    • 1
  • Dragomir Koev
    • 2
  • Lidia Koeva
    • 1
  • Svetoslav Dachev
    • 4
  • Dimitar Tcharaktchiev
    • 2
  • Anastassia Protopopova
    • 4
  • Linda Gonder-Frederick
    • 3
  • William Clarke
    • 1
  1. 1.University of Virginia Health Sciences CenterCharlottesvilleVirginiaUSA
  2. 2.Medical University of SofiaBulgaria
  3. 3.Anastassia Protopopova, Medical University of VarnaBulgaria
  4. 4.District Hospital, RusseBulgaria
  5. 5.University of Virginia Health SystemCharlottesville

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