Effectiveness of HypoAware, a Brief Partly Web-Based Psychoeducational Intervention for Adults With Type 1 and Insulin-Treated Type 2 Diabetes and Problematic Hypoglycemia: A Cluster Randomized Controlled Trial
| العنوان: | Effectiveness of HypoAware, a Brief Partly Web-Based Psychoeducational Intervention for Adults With Type 1 and Insulin-Treated Type 2 Diabetes and Problematic Hypoglycemia: A Cluster Randomized Controlled Trial |
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| المؤلفون: | Maartje de Wit, Jos W. R. Twisk, Frank J. Snoek, Stefanie M. P. A. Rondags |
| المساهمون: | Medical Psychology, Medical psychology, EMGO - Lifestyle, overweight and diabetes, Epidemiology and Data Science |
| المصدر: | Diabetes care, 39(12), 2190-2196. American Diabetes Association Inc. Rondags, S M P A, de Wit, M, Twisk, J W & Snoek, F J 2016, ' Effectiveness of HypoAware, a Brief Partly Web-Based Psychoeducational Intervention for Adults With Type 1 and Insulin-Treated Type 2 Diabetes and Problematic Hypoglycemia: A Cluster Randomized Controlled Trial ', Diabetes Care, vol. 39, no. 12, pp. 2190-2196 . https://doi.org/10.2337/dc16-1614Test Diabetes Care, 39(12), 2190-2196. American Diabetes Association Inc. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Adult, Male, Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Type 2 diabetes, Hypoglycemia, Gee, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Patient Education as Topic, Interquartile range, law, Diabetes mellitus, Surveys and Questionnaires, Internal Medicine, medicine, Humans, Hypoglycemic Agents, Insulin, 030212 general & internal medicine, Advanced and Specialized Nursing, Internet, business.industry, nutritional and metabolic diseases, Odds ratio, Awareness, Middle Aged, medicine.disease, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Relative risk, Female, Medical emergency, business, Follow-Up Studies |
| الوصف: | OBJECTIVE To establish the effectiveness of a brief, partly web-based group intervention, HypoAware, in patients with problematic hypoglycemia, in terms of the reduction of severe hypoglycemic episodes, impaired hypoglycemia awareness, and worries. RESEARCH DESIGN AND METHODS A two-arm, cluster randomized controlled trial was conducted in insulin-treated patients with problematic hypoglycemia in eight Dutch clinics comparing HypoAware with care as usual. Primary outcomes included self-reported severe hypoglycemia, impaired hypoglycemia awareness (Gold score), and worries and distress about hypoglycemia (Hypoglycemia Fear Survey-II/Problem Areas In Diabetes scale hypo-item), assessed at baseline, and at 2, 4, and 6 months of follow-up. We used t tests, nonparametric tests, and intention-to-treat generalized estimation equation (GEE) analyses with linear, logistic, and Poisson or negative binomial models. RESULTS We enrolled 137 participants. Adjusted GEE analyses over four time points showed a nonsignificant 33% fewer episodes of severe hypoglycemia in the HypoAware group compared with the control group (relative risk [RR] 0.67 [95% CI 0.39–1.16], P = 0.150); a significant reduced odds of impaired awareness (odds ratio 0.38 [95% CI 0.15–0.95], P = 0.038), a trend toward 20% fewer worries about hypoglycemia (RR 0.80 [95% CI 0.64–1.01], P = 0.059), and a significant 30% less hypo-distress (RR 0.70 [95% CI 0.56–0.88], P = 0.002). Over the 6-month study duration, participants experienced a median of 2.5 events of severe hypoglycemia (interquartile range [IQR] 1–10) in the control condition versus 1 event (IQR 0–6.5) in the HypoAware group (P = 0.030). There was no significant change in HbA1c level within and between both groups. CONCLUSIONS HypoAware resulted in fewer severe hypoglycemic episodes, significantly improved hypoglycemia awareness, and less hypo-distress in comparison with usual care, and deserves further dissemination. |
| اللغة: | English |
| تدمد: | 0149-5992 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::3ebfe82881b96470d07dd5c0bca9ac3bTest https://doi.org/10.2337/dc16-1614Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....3ebfe82881b96470d07dd5c0bca9ac3b |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 01495992 |
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