Development of a real-time smartphone solution for the management of women with or at high risk of gestational diabetes

Lucy Mackillop, Lise Loerup, Katy Bartlett, Andrew Farmer, Oliver J. Gibson, Jane E. Hirst, Yvonne Kenworthy, Dev A. Kevat, Jonathan C. Levy, Lionel Tarassenko

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1105-1114
Number of pages10
JournalJournal of diabetes science and technology
Volume8
Issue number6
DOIs
StatePublished - Nov 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014 Diabetes Technology Society.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The work was funded by the National Institute of Health Research Biomedical Research Centre Programme, Oxford. LL is funded by the RCUK Digital Economy Programme grant number EP/G036861/1 (Oxford Centre for Doctoral Training in Healthcare Innovation) and the Clarendon Fund.

FundersFunder number
National Institute of Health Research Biomedical Research Centre Programme
Research Councils UKEP/G036861/1
Clarendon Fund

    Keywords

    • Complex intervention development
    • Digital health
    • Gestational diabetes
    • Self monitoring

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