Accelerate the Self Understanding of Blood Glucose through the Summary Screen (ACCESS STUDY)

We previously assessed the effectiveness of a simple self-monitored blood glucose(SMBG) device with the function to display whether a blood glucose level is high or low in different colors (C device) (REFLECT STUDY, 2012 ADA), which reported that an interventional group using the C device and patient education materials showed a significant decrease in HbA1c compared to a group using a monochrome-display device. In our new ACCESS Study, we evaluated the effectiveness of a new SMBG device with an additional summary screen that shows past blood glucose patterns (device V) and a new educational material that advises on such blood glucose patterns. Outpaitients with diabetes mellitus (N=94, HbA1c 7.41 ± 0.85%) were randomly assigned to either an intervention group (N=50) where patients were switched from device C to device V with the new educational material, or to a non-intervention group (N=44) where patients were just switched from device C to device V and did not receive the new educational material. We evaluated the changes in HbA1c and patient satisfaction survey scores 8 weeks later. There was no significant difference in the change in HbA1c at 8 weeks between the intervention group (-0.06%; -0.165 to 0.045) and non-intervention group (-0.01%; -0.136 to 0.113). According to the results of the satisfaction survey, the intervention group showed a higher satisfaction in "Recognition of patterns/trends in blood glucose levels." There was a tendency in improvement of blood glucose pattern/trend recognition by patients by the intervention, there was no impact on HbA1c improvement. However, the outcomes of this study may have been affected by the short 8-week duration, as well as the fact that it was conducted during the period of seasonal change. Since device V and the new educational material improves blood glucose pattern/trend recognition, the results may have been different if a specific plan for blood glucose improvement tailored to each patient was further conveyed to each patient.