Examining the Impact of a Novel Blood Glucose Monitor With Color Range Indicator on Decision-Making in Patients With Type 1 and Type 2 Diabetes and its Association With Patient Numeracy Level

BACKGROUND: Many patients struggle to interpret and respond appropriately to the numerical blood glucose results displayed on their meter, with many regularly taking no action or self-care adjustment for out-of-range results. We recently reported that a glucose meter that provides automatic onscreen information using a color range indicator (ColorSure Technology) improved the ability of patients to categorize their blood glucose results. OBJECTIVE: The objective of this study was to examine how ColorSure Technology (or color) affected patient decision making on blood glucose results and how patient numeracy levels influenced such decisions. METHODS: We invited 103 subjects (56 with type 2 diabetes and 47 with type 1 diabetes) to a face-to-face in-clinic visit in a diabetes care center and showed them glucose results with or without color via interactive computer or paper logbook exercises. Before participating in these exercises, subjects completed surveys on numeracy and their understanding of blood glucose information. RESULTS: Subjects preferentially acted on high glucose results shown with color (55%, 57/103) compared to results without color (45%, 46/103; P=.001). When shown identical pairs of results, subjects preferentially acted on results shown with color (62%, 64/103) compared to results without color (16%, 16/103) (P<.001). Subjects more accurately identified days of the week in which results were low, in range, or high when reviewing logbooks with color (83%, 85/103) than without color (68%, 70/103; P=.012). Subjects with lower numeracy were more likely to consider taking action for high glucose results shown with color (59%, 18/31) than without color (41%, 13/31) and preferentially would take action on results shown with color (71%, 22/31) compared to results without color (16%, 5/31). CONCLUSIONS: Insulin- and noninsulin-using subjects were each more inclined to act when glucose results were shown with color, and associating glucose results with color was viewed as particularly beneficial by subjects with lower numeracy.