Blood glucose awareness training: What is it, where is it, and where is it going?

Management of type 1 diabetes requires a continual balancing of insulin, fuel intake, and metabolic demand (e.g., exercise). This can only be accomplished with knowledge of where one's blood glucose is and where it is going and knowledge of how to manipulate insulin, fuel, and exercise to manage it. Blood Glucose Awareness Training (BGAT) is a psychoeducational intervention that in part addresses these needs. Fifteen research studies from the United States and Europe, involving single-site and multicenter projects, are reviewed. BGAT has been consistently demonstrated to improve the ability to detect and diminish both hypoglycemia and hyperglycemia while reducing the sequelae of extreme blood glucose levels (e.g., episodes of severe hypoglycemia and driving mishaps). BGAT has recently been transformed for internet delivery, making it available both for clinicians to use with their patients and for individuals with type 1 diabetes to pursue as a self-directed tutorial.