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
Authors' conclusion
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.
Study context
- Population
- Adults with T1D and impaired awareness of hypoglycaemia who completed the A2A questionnaire before, 24 weeks and 24 months after the multimodal HypoCOMPaSS intervention (short psycho-educational programme with optimisation of insulin therapy and glucose monitoring); age 48±12 years, diabetes duration 29±12 years (mean±SD)
- Participants
- 91 adults
- Comparison
- A2A cognitions before vs 24 weeks and 24 months after the HypoCOMPaSS intervention
Primary result
As reported in the abstract
baseline, 24 weeks, 24 months
- 'Hyperglycaemia avoidance prioritised' decreased from baseline to 24 weeks, maintained at 24 months (mean±SD, baseline vs 24 weeks vs 24 months); η2p=0.250, p=0.001
- 5.3±0.3 vs 4.3±0.3 vs 4.0±0.3
- 'Asymptomatic hypoglycaemia normalised' decrease from baseline significant at 24 weeks (baseline vs 24 weeks); η2p=0.113, p=0.045
- 1.5±0.3 vs 0.8±0.2
- Predictors of incomplete hypoglycaemia response (≥1 further severe hypoglycaemia episode): higher baseline severe hypoglycaemia rates, higher baseline 'asymptomatic hypoglycaemia normalised' scores, reduced change in 'asymptomatic hypoglycaemia normalised' at 24 weeks, lower baseline 'hypoglycaemia concern minimised' scores
- all p<0.05
Further findings
≥1 severe hypoglycaemic episode over preceding 12 months · baseline, 24 weeks, 24 months
- Baseline
- 91%
- 24 weeks and after 24 months (p=0.001)
- <20%
Original publication
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. Diabetologia. Published 20 December 2022. doi:10.
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