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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EEducation concerning hypoglycemia benefits patients with type 1 diabetes with impaired awareness of hypoglycemia, regardless of the system used to deliver insulin and monitor blood glucose, according to results from the Prevention of Recurrent Severe Hypoglycaemia: A Definitive Randomized Controlled Trial Comparing Optimised MDI and CSII With or Without Adjunctive Real-time Continuous Glucose Monitoring [HypoCOMPaSS; EUCTR2009-015396-27].\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInsulin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EInsulin\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPrevention \u0026amp; Screening\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EEducation concerning hypoglycemia benefits patients with type 1 diabetes (T1D) with impaired awareness of hypoglycemia, regardless of the system used to deliver insulin and monitor blood glucose, according to Stuart Little, MBBS, Newcastle University, Newcastle, United Kingdom, who reported on the Prevention of Recurrent Severe Hypoglycaemia: A Definitive Randomized Controlled Trial Comparing Optimised MDI and CSII With or Without Adjunctive Real-time Continuous Glucose Monitoring [HypoCOMPaSS; EUCTR2009-015396-27].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003ETypically, \u223c25% of patients with T1D have an impaired awareness of hypoglycemia. This lack of knowledge can lead to a markedly higher risk of life-threatening episodes of severe hypoglycemia.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EIn this study, 96 T1D patients with impaired awareness of hypoglycemia were randomized to either the conventional multiple daily injections of insulin aspart or insulin glargine (n=50) or pump-mediated delivery of insulin aspart (n=46). In both groups, glucose was either episodically or continuously monitored. All participants received a standardized 2-hour information program concerning the recognition of risk factors and symptoms of hypoglycemia, which proved equally effective in reducing episodes of hypoglycemia. The primary endpoint was the difference in awareness of hypoglycemia as determined using the Gold score at 24 weeks. Secondary endpoints were measures of overall glycemic control and patient reported outcomes including fear of hypoglycemia and treatment satisfaction.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe participants had a mean age of 49 years (range, 18 to 74 years), mean duration of diabetes of 29 years, and were C-peptide negative. Their impaired awareness of hypoglycemia was \u22654, as measured using the Gold score, which queries knowledge of the onset of hypoglycemia, with the response ranked on a 7-point scale ranging from 1 (\u201calways aware\u201d) to 7 (\u201cnever aware\u201d) [Gold AE et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E 1994]. Two thirds of the participants were women, two thirds had retinopathy, one quarter had nephropathy, and one quarter had concomitant immune-treated thyroid disease. The mean HbA1C level was 8.2%.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EBy 4 weeks, biochemical hypoglycemia measured by continuous monitoring was significantly reduced from 53.3 minutes (3.7% of time) to 24.5 minutes (1.7% of time), \u223c30 minutes less each day (p\u0026lt;0.001 vs baseline). The reduction was sustained over the remaining 20 weeks. At 24 weeks, a statistically significant improvement in the median Gold score from 5 to 4 was evident for all participants regardless of the method of insulin, compared with the baseline score (p\u0026lt;0.001).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe number of episodes of severe hypoglycemia, defined by the American Diabetes Association as hypoglycemia that requires assistance for treatment, was reduced from 9 at baseline to \u0026lt;1 at 24 weeks (p\u0026lt;0.001), with the proportion of patients affected declining from 92% and 77% at 1 year and 6 months prior to the trial, respectively, to just 19% during the trial.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EThe mean number of insulin doses decreased significantly by about 8 units over the 24-week trial (p\u0026lt;0.001). Both treatment arms displayed similarities in HbA1C values, Gold score, number of episodes of severe hypoglycemia, mean insulin dose, and fear of hypoglycemia. Participants who received insulin via a pump expressed greater satisfaction with treatment.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EProf. Little and his colleagues concluded that impaired awareness of hypoglycemia can be improved and recurrent hypoglycemia can be prevented through strategies targeted at avoiding severe biochemical hypoglycemia in a high-risk population affected by diabetes for almost 30 years. This benefit of education is more influential than the technology of insulin delivery.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/11\/14.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}