Development of a Real-Time Smartphone Solution for the Management of Women With or at High Risk of Gestational Diabetes

• Published in: Journal of diabetes science and technology Vol. 8; no. 6; pp. 1105 - 1114
• Main Authors: Mackillop, Lucy, Loerup, Lise, Bartlett, Katy, Farmer, Andrew, Gibson, Oliver J., Hirst, Jane E., Kenworthy, Yvonne, Kevat, Dev A., Levy, Jonathan C., Tarassenko, Lionel
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.11.2014
• Subjects: Adult; Blood Glucose Self-Monitoring - methods; Cell Phone; Diabetes, Gestational - blood; Female; Humans; Mobile Applications; Original; Pregnancy; Telemedicine - instrumentation; Telemedicine - methods; complex intervention development; digital health; gestational diabetes; self monitoring
• ISSN: 1932-2968; 1932-3107
• DOI: 10.1177/1932296814542271

Background: Gestational diabetes mellitus (GDM) is defined as new onset or recognition of glucose intolerance in pregnancy. Evidence supports tight blood glucose regulation to prevent adverse maternal and fetal outcomes. Finger-prick blood glucose (BG) testing with frequent clinic review remains the most common method of managing diabetes in pregnancy. The prevalence of GDM is rising globally, pressuring resource-limited services. Objectives: We have developed an intuitive, interactive, reliable, and accurate management system to record BG measurements and deliver management of GDM remotely. Methods: Following an initial scoping phase, a prototype software application was developed using an Android smartphone with BG meter linkage via Bluetooth. A custom website was built for clinician review of the data transmitted by the smartphone. After system refinement, further evaluation was undertaken for usability and reliability in a 48-patient service development project. Results: Women used the system for an average of 13.1 weeks. In all, 19 686 BG measures were transmitted, 98.6% of which had a meal tag. A total of 466 text messages were transmitted. A mean of 30 BG readings per woman per week were transmitted, and 85% of women submitted the minimum requirement of 18 readings per week. Discussion: We have developed a novel, real-time, smartphone-based BG monitoring management system that allows clinician review of real-time patient-annotated BG results. Results indicate high usage and excellent compliance by women. Conclusion: Robust clinical, economic, and satisfaction evaluations are required. To address these requirements, we are currently conducting a randomized controlled pilot trial.