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Aims/Introduction This 6‐month, single‐center, prospective, open‐labeled, randomized trial was designed to investigate whether physicians’ diabetes self‐management education using an education tool developed by the Japan Association of Diabetes Education and Care and a self‐monitoring of blood glucose (SMBG) analyzer improves glycemic control in individuals with type 2 diabetes receiving insulin and SMBG. Materials and Methods Participants were randomized into intervention (I) and control (C) groups. Both groups received physicians’ diabetes self‐management education at each hospital visit, whereas the Japan Association of Diabetes Education and Care education tool and the SMBG readings analyzer was used in group I, but not group C. All participants filled out a diabetes treatment‐related quality of life form and an original questionnaire on SMBG use with five questions (Q1–Q5) before and after the study period. Results A total of 76 individuals were recruited and randomized. Glycated hemoglobin (HbA1c) was significantly improved during the study period in group I, whereas no significant change was observed in group C. The change in HbA1c was greater in group I, although it did not reach statistical significance. The diabetes treatment‐related quality of life total score was not changed in either group. Interestingly, the score of Q1 (“How important is SMBG to you?”) in the SMBG questionnaire was unchanged in group I, whereas it was significantly decreased in group C. HbA1c change was independently associated with changes in insulin dose and SMBG Q1 score. Conclusion Greater HbA1c‐lowering by physicians’ diabetes self‐management education using the Japan Association of Diabetes Education and Care education tool and SMBG analyzer in individuals with type 2 diabetes receiving insulin and SMBG was suggested, but not confirmed., Use of the newly developed Japan Association of Diabetes Education and Care Diabetes Education Card System Program with a self‐monitoring of blood glucose readings analyzer improves glycated hemoglobin, likely by facilitating patient–physician interaction in individuals receiving insulin and self‐monitoring of blood glucose.

Aims/Introduction The present multicenter, cross‐sectional survey was initiated to evaluate self‐monitoring of blood glucose (SMBG)‐associated mental distress among patients with diabetes. Materials and Methods The survey was carried out in patients with type 1 diabetes and type 2 diabetes using SMBG recruited from 42 medical institutions. Profiles of Mood States 2 and diabetes therapy‐related quality of life questionnaires were used to evaluate mood status and health‐related quality of life. Two original questionnaires were also developed to evaluate SMBG ‘importance,’ ‘painfulness’ and ‘confidence’ among patients, and to evaluate physician attitudes to SMBG use. Results Questionnaires from 517 type 1 diabetes and 1,648 type 2 diabetes patients showed that 46.0% of type 1 diabetes and 37.5% of type 2 diabetes patients reported ‘painfulness,’ and that these patients reporting ‘painfulness’ showed significantly higher Profiles of Mood States 2 scores, lower diabetes therapy‐related quality of life scores and higher glycated hemoglobin compared with those not reporting ‘painfulness,’ whereas the number of their daily SMBG tests were comparable. Patients reporting ‘painfulness’ also reported that SMBG use was significantly less important. Whether or not patients recognized the importance of SMBG use was well correlated with the frequency of physicians checking patient diaries. Conclusions Type 1 diabetes and type 2 diabetes patients reporting ‘painfulness’ in SMBG use had more mental distress, lower health‐related quality of life and higher glycated hemoglobin regardless of their number of daily SMBG tests. The importance of SMBG use was recognized less by patients experiencing pain, and the importance of SMBG use was recognized more in medical institutions in which physicians regularly checked SMBG diaries to provide meaningful feedback to patients in clinical settings.

Dishes containing dietary fibers are eaten first, and the protein and fat courses are then followed by the carbohydrate dishes.