A Comprehensive Evaluation of a Novel Color Range Indicator in Multiple Blood Glucose Meters Demonstrates Improved Glucose Range Interpretation and Awareness in Subjects With Type 1 and Type 2 Diabetes

Abstract

Self-monitoring of blood glucose (SMBG) is an integral component of effective diabetes management, allowing patients to evaluate their individual response to therapy and assess whether individual glycemic targets are being achieved.1,2 Appropriate education addressing SMBG interpretation and particularly the response to "out of-range" blood glucose (BG) results are prerequisites for the useful performance of SMBG.3,4 Recent studies have highlighted the issue of interpreting and responding to SMBG. A study in 207 patients with T2DM 5 investigating perceptions of high BG results demonstrated that the subjects were more tolerant of high BG levels than is clinically advisable. In addition, a survey of 886 people with T2DM showed that about half of insulin and non-insulin-using patients with T2DM regularly took no action for out-of-range BG values (low or high) with any self-care adjustments. 6 We recently reported that a blood glucose meter (BGM) that provides automatic on-screen glucose range information using a color range indicator (CRI) We previously demonstrated that people with type 2 diabetes (T2DM) can improve their ability to categorize blood glucose (BG) results into low, in range, or high glycemic ranges after experiencing a color range indicator (CRI or ColorSure™ Technology) in a single meter. This study examined whether a CRI was effective in people with type 1 (T1) or T2DM when used in 3 glucose meters.Methods: A total of 179 subjects (139 T2DM and 40 T1DM) classified BG values as low, in range, or high based on individual current knowledge. Subjects then experienced the CRI which showed whether different BG values were low, in range, or high. After CRI interaction, subjects repeated the classification. Results:Following interaction with the CRI, subjects significantly improved their ability to categorize BG results into low, in range, and high glycemic ranges by 27.9% (T2DM) and 27.2% (T1DM) (each P < .001). Improvement was not accompanied by an increase in time spent categorizing results. There was no difference in classification ability between subjects with T1 or T2DM. There was also no correlation between HbA1c, numeracy level, test frequency, or duration of diabetes and the ability to correctly classify results. Subjects agreed the CRI feature helped them easily interpret glucose values and improved their awareness of glucose ranges. Conclusion:Interaction with a CRI improved the ability of subjects with T1 and T2DM to interpret and categorize BG values into recommended glycemic ranges, irrespective of the glucose meter providing the CRI insights.

Establishing Expert, Multi-Disciplinary, Peer-Reviewed Consensus to Lead a Paradigm Shift in Optimal Blood Glucose Management

“…This would offer a synergistic benefit. There is 97.2% agreement among respondents that BGM offers a means to offer positive reinforcement in support of patient decisions, reflecting recent published data [ 2 , 12 ].…”

“…Among respondents, 99.5% agree that effective BGM is a necessary component of patient education; in addition, the importance of access to BGM data and of understanding trends and patterns is strongly supported (statements 23 and 24). Access to feedback on their progress helps patients to take action to improve their diabetes control or continue with previous positive actions [ 2 ]. There is strong agreement that virtual data and applications can support education at home.…”

“…Respondents strongly indicate (92.7%) that evidence is important in improving patient care and that it should inform choices relating to BGM. Recent evidence [ 2 ] shows that switching patients to BGM systems featuring color range indicators was associated with improvements in glycated hemoglobin levels compared to subjects using a wide selection of marketed BGM systems without color support [ 14 ]. Despite this, respondents support the assertion (78.5%) that there is a lack of evidence that more expensive BGM systems improve outcomes, suggesting that respondents may not be fully aware of recent innovations and published data.…”

“…The first BGM meter was introduced in 1970 [ 1 ], and available technology has evolved markedly since then. In today’s technology-rich environment, self-monitoring of blood glucose is an integral part of effective diabetes management [ 2 ], allowing patients to monitor their glycemic status and adjust their therapy accordingly.…”

“…Modern healthcare requires that long-term conditions are managed in a shared and collaborative way between the patient and all stakeholders involved in their care, rather than solely by the patient or healthcare professionals (HCPs). Despite clear demonstrations of the benefits of BGM meters that provide feedback to patients [ 2 ], and diabetes being almost universally managed in the UK by NHS professionals, there is an apparent lack of clarity within the NHS regarding emerging BGM technologies and their potential to positively impact service delivery and increase resource efficiency while supporting patient empowerment. This was demonstrated in a survey of over 1000 BGM users carried out by Diabetes UK [ 3 ], with the responses suggesting that NICE (National Institute for Health and Care Excellence) guidance is not always implemented as recommended for type 1 [ 4 ] and type 2 [ 5 ] diabetes.…”