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
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://hdl.handle.net/10216/147368 |
Resumo: | 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 (2p=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 (2p=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. Clinical trials registration: www.isrctn.org: ISRCTN52164803 and https://eudract.ema.europa.eu: EudraCT2009-015396-27. Graphical abstract: [Figure not available: see fulltext.]. (c) 2022, The Author(s). |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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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 studyCiências da Saúde, Ciências médicas e da saúdeHealth sciences, Medical and Health sciencesAims/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 (2p=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 (2p=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. Clinical trials registration: www.isrctn.org: ISRCTN52164803 and https://eudract.ema.europa.eu: EudraCT2009-015396-27. Graphical abstract: [Figure not available: see fulltext.]. (c) 2022, The Author(s).20222022-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10216/147368eng0012-186X10.1007/s00125-022-05847-7Sepúlveda, EJacob, PPoínhos, RuiCarvalho, DSelene VicenteSmith, ELShaw, JAMSpeight, JChoudhary, Pde Zoysa, NAmiel, SAinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-29T13:03:40Zoai:repositorio-aberto.up.pt:10216/147368Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T23:32:51.101847Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
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 |
title |
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 |
spellingShingle |
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 Sepúlveda, E Ciências da Saúde, Ciências médicas e da saúde Health sciences, Medical and Health sciences |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
author |
Sepúlveda, E |
author_facet |
Sepúlveda, E Jacob, P Poínhos, Rui Carvalho, D Selene Vicente Smith, EL Shaw, JAM Speight, J Choudhary, P de Zoysa, N Amiel, SA |
author_role |
author |
author2 |
Jacob, P Poínhos, Rui Carvalho, D Selene Vicente Smith, EL Shaw, JAM Speight, J Choudhary, P de Zoysa, N Amiel, SA |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Sepúlveda, E Jacob, P Poínhos, Rui Carvalho, D Selene Vicente Smith, EL Shaw, JAM Speight, J Choudhary, P de Zoysa, N Amiel, SA |
dc.subject.por.fl_str_mv |
Ciências da Saúde, Ciências médicas e da saúde Health sciences, Medical and Health sciences |
topic |
Ciências da Saúde, Ciências médicas e da saúde Health sciences, Medical and Health sciences |
description |
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 (2p=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 (2p=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. Clinical trials registration: www.isrctn.org: ISRCTN52164803 and https://eudract.ema.europa.eu: EudraCT2009-015396-27. Graphical abstract: [Figure not available: see fulltext.]. (c) 2022, The Author(s). |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022 2022-01-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://hdl.handle.net/10216/147368 |
url |
https://hdl.handle.net/10216/147368 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0012-186X 10.1007/s00125-022-05847-7 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799135639273209856 |