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 .
Evaluation of a treatment and teaching refresher programme for the optimization of intensified insulin therapy in type 1 diabetes.
OBJECTIVE Evaluation of an ambulatory diabetes teaching and treatment refresher programme ( DTTP ) for the optimization of intensified insulin therapy in patients with type 1 diabetes ( refresher course ) . METHODS 85 out patients took part in this prospect i ve multicentre trial . Metabolic and psychosocial data were analyzed at baseline ( V1 ) , 6 weeks ( V2 ) and 12 months after DTTP ( V3 ) . RESULTS In patients with baseline HbA1c>7 % ( 88 % ) , HbA1c decreased by 0.36 % ( p=0.004 ) . The percentage of patients with HbA1c≤7 % increased from 21.3 to 34.9 % and with HbA1c above 10 % decreased from 6.6 to 1.6 % at V3 . The incidence of hypoglycaemia decreased significantly : non severe hypoglycaemia from 3.31 to 1.39 episodes/pat/week ( p=0.001 ) and severe hypoglycaemia from 0.16 to 0.03 episodes/pat/year ( p=0.02 ) . The treatment satisfaction increased by + 10 of maximal ±18 points . The negative influence of diabetes on quality of life decreased from -1.93 to -1.69 points ( p=0.031 ) . CONCLUSION In a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy , metabolic control , treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage , number of injections or insulin species . PRACTICE IMPLICATION S This DTTP is effective for the optimization of intensified insulin therapy
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 .