In her first article, Gayle Richards outlines why she was drawn to Blood Glucose Awareness Training and how this interest has led to an educational trip to the United States and Netherlands.
My journey to the USA and Netherlands began with a review of a NICE guideline and an email.
The guideline
The Northern Devon Healthcare Trust, which I work for, asked me to review NICE guideline NG17 (NICE, 2015) and my interest was aroused by section 1.3.7, which stated: “Consider the Blood Glucose Awareness Training (BGAT) programme for adults with type 1 diabetes who are having recurrent episodes of hypoglycaemia.” I have worked as a diabetes specialist nurse for nearly 30 years in four different organisations, including a teaching hospital, but could not recall a UK-based structured approach to such a programme.
I started to investigate what was meant by BGAT, what the programme involved and what was being delivered in UK. Literature searches pointed to key work by Professor Daniel Cox in Virginia, who had published key research on the benefits of BGAT in the early 2000s (Cox et al, 2001), and Professor Frank Snoek in Amsterdam, who had recently presented work using an internet-based education programme at the American Diabetes Association conference (since published, Rondags et al, 2016). At that point there did not appear to be any work in the UK.
The email
An email was sent informing nurses about the Winston Churchill Memorial Trust (WCMT), which was set up using donations from the public following the death of Winston Churchill. The WCMT awards Travel Fellowships that give individuals the opportunity to travel to other countries to observe, learn and research aspects of care. Learning can then be brought back to the UK. This felt like my opportunity to learn about BGAT from the people who were experts in that field.
Two successive online applications were completed. These involved an outline of my plans and how I would implement learning into UK diabetes care.
I was excited to be selected for interview at the WCMT offices in London. The panel were keen to know about BGAT and what I would learn. They also suggested that there were other aspects of diabetes that I could explore while visiting other centres.
Being awarded the Travel Fellowship was an enormous privilege. The Trust specifically state that it is more than the opportunity to see your chosen project area. It is also an opportunity for personal development. The importance of having fun is also stressed.
Planning my trip
I started confirming tentative contacts I had made during the application process, however key people such as Daniel Cox have now retired so my initial plans changed. I timed my visit so I could attend the American Diabetes Association conference in San Diego in order to get the maximum educational benefit out of the trip.
I decided to visit the Joslin Diabetes Center in Boston to observe the work of John Zrebiec and Marilyn Ritholz. Throughout my career, the Joslin Center has been legendary, especially in the area of patient education programmes. My plan is to observe as many education sessions and clinics as I can this month. In autumn, I plan to visit the Netherlands to spend time with Frank Snoek.
This is a trip with many firsts for me. It is the first time that I have seen diabetes care in another country, the first time using Airbnb and the first I have been away from my family for such a long time. This is all part of how the WCMT encourages the idea of travelling facilitating self-development. The journey has started.
To apply for a WCMT grant, visit www.wcmt.org.uk/apply. This year’s deadline is 19 September.
References
Cox DJ, Schlundt D, Gonder-Frederick L et al (2001) Blood Glucose Awareness Training (BGAT-2). Diabetes Care 24: 637–42
National Institute for Health and Care Excellence (2015) NICE guideline NG17. Type 1 diabetes in adults: diagnosis and management. www.nice.org.uk/guidance/ng17 (accessed 10.07.17)
Rondags SMPA, de Wit M, Twisk JW, Snoek FJ (2016) Effectiveness of HypoAware, a brief partly web-based psychoeducational intervention for adults with type 1 and insulin-treated type 2 diabetes and problematic hypoglycaemia: a cluster randomized controlled trial. Diabetes Care 39: 2190–6
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