Gestational diabetes mellitus (GDM) affects 5% – 16% of all UK pregnancies, causing raised blood glucose levels. Controlling these raised levels using lifestyle and dietary changes along with medication is important for the health of the mother and baby. As pregnancy progresses, medication requirements vary, requiring frequent review and adjustments.
Usually, pregnant women with GDM measure their blood glucose up to six times per day, using an electronic blood glucose meter, writing the results in a paper diary. They visit the hospital every two to four weeks, where healthcare professionals review the paper results and adjust the medication dose as necessary. The inconvenience and cost of GDM for pregnant women and the NHS is considerable.
The GDm-health management system, designed with patients and clinicians through the NIHR Oxford Biomedical Research Centre, is designed to reduce inconvenience and cost, whilst improving outcomes for the mother and baby. A smartphone (iOS or Android) app, connected wirelessly to the woman’s blood glucose meter, allows women to annotate glucose readings. The app provides visual feedback on blood glucose control to the patient on the smartphone. The system allows communication between healthcare professionals and patients, and allows professionals to send text messages to the patient’s phone to help manage their condition. Professionals use GDm-health via a bespoke webpage, allowing them to record changes in therapy and to communicate between healthcare professionals – ideal for team-based care. Electronic capture of data allows detailed auditing of care and outcomes.
A randomised controlled trial comparing clinical, economic and satisfaction measures between women using the GDm-health management system and those receiving usual care was completed in 2016. GDm-Health was licenced to Sensyne Health plc in 2017. Since then, 56 Trusts have signed up to use GDm-Health, representing 47% of NHS Trusts in England. Over 14,400 women have used the system recording over 2.7 million blood glucose values (as of September 2020). GDm-Health is being used by an average of 1282 new patient users per month. This data allowed development of the first algorithm to predict which women will need medication to manage GDM, helping midwives and doctors provide responsive, individualised care.