Use of Color Range Indicator Technology on Point-of-Care Meters May Ease Self-Management of Blood Glucose

Abstract

After attending this year's 4th Artificial Pancreas Workshop at the National Institutes of Health, 1 I was inspired by one of the panelists' comments on the tools available to people with diabetes. The individual, a person with type 1 diabetes who also happened to be an industrial design professional, criticized the manufacturers for deficiencies in the user interface of various technologies used by people with diabetes. This is not surprising to those of us who are innovators, clinicians or researchers in the field as we have all come across difficult to read screens (glucose meters or insulin pumps), difficult to activate buttons, poor choice of colors or features, and so on. An obvious question is: are manufacturers of those devices not sufficiently attentive to the users' needs? It is indeed challenging for people with diabetes to remain vigilant about their glycemic control and take proper action, almost hourly, to maintain glucose levels within recommended ranges. It would however be too simplistic to suggest that technology alone could ensure good control although it is fair to say that careful consideration of human factors when designing these critical tools could help maximize the patient's ability to self-manage their blood glucose (BG) and remain in control. 2In that respect, the study by Grady et al 3 is timely and exciting striving toward better understanding of relevant human factors in the design of their glucose meter displays. Although the study was designed and performed by the device manufacturer, their investigation focused on meaningful device optimization objectives that could be important to improving diabetes self-management:1. How do people with type 1 and 2 diabetes respond to a bright color range indicator (CRI, ColorSure™ technology) on their point-of-care meter, and is there a difference in this response between meters that display a CRI color range bar versus a CRI color dot with a simple text message to indicate out of range values? 2. Are the numeracy skills of people with diabetes related to their interpretation of self-monitoring of blood glucose (SMBG) data?The fact that nearly half of people with type 2 diabetes are still having difficulty with the interpretation and use of their SMBG data has been a persistent problem, raising once again the nagging question of why are so many people with diabetes not able to achieve clinically recommended BG targets using available point-of-care technology. Polonsky et al showed from their large survey of people with type 2 diabetes that about 50% of insulin and non-insulin using patients took no action for low or high out-of-range BG values. 4 It is also intriguing that people with diabetes seem more tolerant AbstractThe study by Grady et al is timely and exciting striving toward better understanding of relevant human factors in the design of their glucose meter displays. Their investigation focused on meaningful device optimization objectives that could be important to improving diabetes self-management. Grady et al are to be complimente...

Use of Blood Glucose Meters Featuring Color Range Indicators Improves Glycemic Control in Patients With Diabetes in Comparison to Blood Glucose Meters Without Color (ACCENTS Study)

“…3 Others have observed that more appropriate decisions are made when BGMs display information that prompts users toward more favorable diabetes management decisions. 4 This is important given in a study of BG perceptions only 28% of patients considered results >235 mg/dl as high. 5 Another study found 56% of patients did not respond regularly to out-of-range BG readings with any self-care adjustments.…”

Budget Impact of Improved Diabetes Management by Utilization of Glucose Meters With a Color-Range Indicator—Comparison of Five European Healthcare Systems

“…10-12 Evidence indicates that the use of a CRI-based GM improves the health literacy by engaging the patients in SMBG, and therefore, acting in a timely manner on blood glucose level. 13…”

“…[10][11][12] Evidence indicates that the use of a CRI-based GM improves the health literacy by engaging the patients in SMBG, and therefore, acting in a timely manner on blood glucose level. 13 A recent randomized control trial (RCT)-ACCENTScompared CRI-based GMs (OneTouch Verio Flex (Flex) and OneTouch Verio (Verio), LifeScan, Wayne, PA, United States) with GMs without CRI to analyze the impact of CRI on glycemic control in patients with type 1 and type 2 diabetes mellitus (T1DM and T2DM). The RCT demonstrated a statistically significant and clinically meaningful reduction (0.36%) in HbA1c when using Flex and Verio meters in patients with T1DM and T2DM.…”