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Aims/Introduction We devised a new system called 'Educational Guidance' (E-Guide) for nutritional education based on self-efficacy. The present study aimed to examine the effects of E-Guide use on glycemic control among patients with type 2 diabetes. Materials and Methods We carried out an interventional and observational study that included 74 patients with type 2 diabetes. The extent of glycemic control in the 39 patients who received guidance through the E-Guide (E-Guide group) was compared with that of 35 patients who received conventional nutritional guidance (control group). We carried out a 1-year follow-up survey (subanalysis) based on the electronic health records of 18 patients from the E-guide group and 19 patients from the control group. These patients continued treatment at Hikone Municipal Hospital, Hikone, Shiga, Japan. Changes in glycated hemoglobin levels, body mass index and medication dose were examined from time of enrollment to the end of the 1-year intervention, and during the 1-year follow-up. Results Decreases in glycated hemoglobin levels were more pronounced in the E-Guide group than in the control group during the intervention period ( P < 0.05). The levels further decreased during the follow-up period ( P < 0.01). In the E-Guide group, body mass index decreased significantly throughout the follow-up period ( P < 0.001). Additionally, increased medication doses were significantly less common in the E-Guide group than in the control group ( P < 0.01). Conclusions Intervention based on our 'E-Guide' is more useful and powerful than the conventional methods for glycemic control and self-care behavior among patients with type 2 diabetes in Japan. [ABSTRACT FROM AUTHOR]