These were able to reduce SH and improve glycemic control , with greater benefit from the latter two techniques in improving IAH .
Technological interventions ( insulin pump therapy , continuous glucose monitoring , and sensor-augmented pump ) reduced SH , improved glycemic control , and restored awareness when used in combination with structured education and frequent contact .
This review provides evidence for the effectiveness of a stepped-care approach in the management of patients with IAH  , initially with structured diabetes education in flexible insulin therapy , which may incorporate psychotherapeutic and behavioral therapies , progressing to diabetes technology , incorporating sensors and insulin pumps , in those with persisting need
OBJECTIVE Impaired awareness of hypoglycemia ( IAH ) increases the risk of severe hypoglycemia ( SH ) sixfold and affects 30 % of adults with type 1 diabetes ( T1D ) .
This systematic review and meta- analysis looks at the educational , technological , and pharmacological interventions aim ed at restoring hypoglycemia awareness ( HA ) in adults with T1D .
A Multicenter Evaluation of Blood Glucose Awareness Training-II
OBJECTIVE Blood glucose awareness training ( BGAT ) teaches individuals with insulin-dependent diabetes to more accurately estimate/detect their blood glucose ( BG ) fluctuations . It has not , however , consistently result ed in improved ability to detect low BG . To assess an enhanced version of BGAT ( BGAT-II ) , with more focus on increasing sensitivity to low BG events , a multicenter study was undertaken . Following up on previous findings that BGAT is most effective with individuals who are least accurate in estimating BG , this study explicitly recruited subjects who did and did not report reduced awareness of hypoglycemia . RESEARCH DESIGN AND METHODS Seventy-eight subjects from three research sites participated in a repeated baseline design . Subjects ' BG estimation accuracy and BG profiles were assessed 6 months before , immediately before , and immediately after BGAT-II . RESULTS Post-treatment , BGAT-II led to better overall accuracy in detecting BG fluctuations and better detection of both low and high BG levels . This was achieved while the number of low readings of self-monitoring of blood glucose ( SMBG ) was reduced . Reduction in the number of low SMBG events was significant only for subjects reporting awareness of hypoglycemia . Detection of low BG was significant only for subjects reporting reduced awareness of hypoglycemia . Both groups demonstrated equivalent improvements in detection of high BG levels .  CONCLUSIONS BGAT may be an eﬀective behavioral strategy for reversing hypoglycemic unawareness and an adjunct to intensive insulin therapy to reduce the occurrence of severe hypoglycemia
These were able to reduce SH and improve glycemic control , with greater benefit from the latter two techniques in improving IAH .
Technological interventions ( insulin pump therapy , continuous glucose monitoring , and sensor-augmented pump ) reduced SH , improved glycemic control , and restored awareness when used in combination with structured education and frequent contact .
This review provides evidence for the effectiveness of a stepped-care approach in the management of patients with IAH  , initially with structured diabetes education in flexible insulin therapy , which may incorporate psychotherapeutic and behavioral therapies , progressing to diabetes technology , incorporating sensors and insulin pumps , in those with persisting need
OBJECTIVE Impaired awareness of hypoglycemia ( IAH ) increases the risk of severe hypoglycemia ( SH ) sixfold and affects 30 % of adults with type 1 diabetes ( T1D ) .
This systematic review and meta- analysis looks at the educational , technological , and pharmacological interventions aim ed at restoring hypoglycemia awareness ( HA ) in adults with T1D .