Diabetes Reflect Study: Redefining Fundamental Learning of SMBG through Educational Color Tools

Aims: To investigate the effects of a newly developed color-coded educational glucose control instruction (COLOR), combined with a color-displayed glucose meter on changes in type-2 diabetes patient’s behavior and their HbA1c levels. Material and Methods: Patients using a COLOR-self-monitoring of blood glucose (SMBG) method were instructed to record daily blood glucose levels with red (high glucose ≥ 180 mg/dL) or blue (low glucose ≤ 70 mg/dL) colored circles on their SMBG notebooks according to the colors displayed on the glucose meter. Results: COLOR-SMBG showed an improved the actual behavior modification scores by 14% compared to Conventional group at 1-month follow-up (p < 0.05). The mean HbA1c levels of COLOR-SMBG significantly decreased at 2 months (0.14% ± 0.28%, p < 0.01), 4 months (0.31% ± 0.48%, p = 0.05), and 6 months (0.39% ± 0.49%, p = 0.01) follow-up. Conclusions: The results suggest for the first time the usefulness of the instructional intervention using COLOR-SMBG for patients with type 2 diabetes. This trial was registered with UMIN (No. UMIN000011767).