ADIPS 2023 Resource utilisation and pregnancy outcomes of smartphone-based interactive blood glucose management in gestational diabetes mellitus (#50)
Introduction
Treatment of gestational diabetes mellitus (GDM) to optimise glycaemic control and improve pregnancy outcomes requires frequent clinical review of blood glucose levels (BGLs)1. This creates a significant treatment burden on affected women and their healthcare providers.
The Sunshine Coast Hospital and Health Service (SCHHS) has transitioned its model of care to include the use of the NET-Health smartphone application-based, interactive blood glucose monitoring system. The application facilitates real-time transmission of BGL data to a central server, with software identifying glycaemic trends above safe targets and prompting automatically generated alerts to healthcare staff. A pilot study of this application at the SCHHS showed reduced frequency of care and resource utilisation without compromising outcomes2. Measured patient satisfaction was high.
Aims
This retrospective cohort analysis aims to review all women who have utilised the NET-Health application for management of GDM since its adoption by SCHHS. We will assess whether this new model of care, adapted in large scale, continues to reduce treatment burden on staff and patients compared with the traditional model of care.
Methods
Over 1000 women with GDM managed via the application, who completed their pregnancy between October 2019 to March 2023 will be compared with 149 matched historical control cases who were managed via the traditional model of care prior to the introduction of the application. The primary outcome is resource utilisation measured as occasions of service (OOS). Secondary outcomes include comparison of gestation at delivery, maternal gestational weight gain, maternal complications, neonatal birth weight and neonatal complications.
Hypothesis
We hypothesise that the introduction of the NET-Health smartphone application-based interactive blood glucose management system as the standard of care for management of women with GDM has reduced the treatment burden on patients and the multidisciplinary treating team via more efficient resource utilisation, measured by reduced OOS, without negative impacts on maternal or neonatal outcomes. Data collection for the study is underway and we will present preliminary data pertaining to the impact of the remote monitoring platform.
- Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group, 2005. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. The New England Journal of Medicine, 352:2477-86.
- Poulter, S.E., Meloncelli, N, Mack, M., 2022. Use of a smartphone-based, interactive blood glucose management system in women with gestational diabetes mellitus: A pilot study. Diabetes Research and Clinical Practice, 185, p.109224.