10 Apr 2018
21 month study shows positive results for gestational diabetes smartphone app
App developed as part of a collaboration between Engineering Science, Oxford University Hospitals NHS Foundation Trust and Drayson Health
Gestational diabetes mellitus (GDM), defined as new onset or recognition of glucose intolerance in pregnancy which resolves following birth, is increasing in prevalence around the world, driven by demographic and lifestyle changes. Gestational diabetes is a serious condition which can cause complications during pregnancy.
The GDm-Health app is a digital pharmaceutical intervention to improve gestational diabetes management. A randomised controlled trial (RCT) involving 203 patients showed significantly higher patient satisfaction with care, significantly better adherence to blood glucose monitoring, a significant reduction in caesarean sections, and a reduction in pre-term births.
The most common method of managing diabetes in pregnancy is finger-prick blood glucose testing, with women recording their blood glucose results in paper diaries around six times a day. These are then reviewed regularly by doctors and midwives in clinic. It is a time-consuming process, open to the risk of transcription errors.
GDm-Health is a direct patient-to-clinician blood glucose monitoring management system that allows clinicians to review patient-annotated blood glucose results in real time. It is based on a smartphone app that enables women to connect a blood glucose meter to their smartphone using Bluetooth or NFC (near field communication) and then automatically collect blood glucose measurements.
These measurements, along with any text-based commentary the woman wishes to record, are transmitted directly to the clinical team where they may be reviewed via a web-based software application.
As a result, clinicians get more time to focus on the woman's care needs rather than collecting and recording data, and have the ability to prioritise care to women most at need.
The RCT was made possible by funding and scientific input from the NIHR Oxford Biomedial Research Centre, whose Technology and Digital Health Theme is led by Head of Department Professor Lionel Tarassenko.
He commented: "This trial is another example of how self-management by patients using digital health tools can be secure, gives them greater control of their condition and reduces the number of times they have to visit a clinic".
"It improves communication between patient and clinical staff, reduces the amount of time spent by nurses and midwives on administrative tasks and allows for accurate auditing of data about care and outcomes."
Dr Lucy Mackillop, Consultant Obstetric Physician at OUH, is the clinical lead for the development of GDm-Health and led the RCT.
She says: "GDm-Health was developed in partnership with patients, clinicians and engineers. This trial was conducted in real world conditions within the NHS and demonstrates the potential utility of GDm-Health to improve care and outcomes for women with gestational diabetes and their babies."
The RCT concluded: 'Further studies are required to explore whether digital health solutions can promote desired self-management lifestyle behaviours and dietetic adherence, and influence maternal and neonatal outcomes. Digital blood glucose monitoring may provide a scalable, practical method to address the growing burden of GDM around the world'.
Lord Drayson, Chairman and CEO of Drayson Health, added: "Our focus now shifts to making GDm-Health widely available across the UK and internationally, helping to improve maternal and neo-natal outcomes despite the rising prevalence of diabetes in pregnancy".
The results were presented, and made available Open Access, in JMIR Mhealth and Uhealth (NCT01916694).
Article courtesy of Drayson Health