Individuals with insulin-dependent diabetes mellitus (IDDM) are at risk of both the severe long-term complications of hyperglycemia and the dangerous immediate consequences of hypoglycemia. Intensive diabetes treatment delays the onset and slows the progression of complications, but places patients at increased risk of hypoglycemia. Yet, individual patients experience hypoglycemia differently. Therefore, nurses must have accurate information about patients' responses. By participating in an ongoing study that intensifies patients diabetes treatment, this research proposes to examine 3 issues that will influence individualization of different aspects of patient education programs. Specifically: 1) Do patients recognize hypoglycemia and their own hypoglycemia-induced cognitive dysfunction? 2) Do symptom and cognitive results obtained from laboratory procedure actually reflect real life hypoglycemia? 3) Do patients who participate in Blood Glucose Awareness Training (BGAT) programs achieve and maintain improved levels of diabetes control after study completion and then at 6 month and 1 year follow-up.? The results obtained from this proposed investigation will provide much-needed information about patients' experience of blood glucose fluctuations and the effectiveness of BGAT for safer diabetes control. Nurse educators can tailor educational programs to meet the individual needs of diabetes patients. More appropriate education will, in turn, lead to more supportive and successful adaptation to diabetes and its treatment.
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