Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Eberle, Claudia; Löhnert, Maxine; Stichling, Stefanie

doi:10.2196/24982

Cited by 11 publications

(14 citation statements)

References 48 publications

(178 reference statements)

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“…Several risk factors for HIP have been identified, such as previous GDM, family history of diabetes, ethnicity, higher maternal age, pre-pregnancy obesity, or overweight. Excess neonatal and maternal short- and long- term complications are associated with HIP ( 8 , 9 ). Furthermore, hyperglycemia is also correlated with inflammation including kisspeptin.…”

Section: Discussionmentioning

confidence: 99%

Comparison of insulin requirements across gestation in women with hyperglycemia in pregnancy: A prospective cohort study

Rao

Ping²

2022

Front. Endocrinol.

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ObjectivesThe aim of this study is to explore the daily insulin dose and the percentage change in preprandial and basal insulin dosage of women with different types of hyperglycemia in pregnancy (HIP) during the whole gestation and postpartum period.MethodsA total of 121 subjects with HIP requiring insulin therapy were enrolled from a prospective cohort consisted of 436 pregnant women with hyperglycemia. The subjects were divided into three groups: Group 1 [type 1 diabetes mellitus (T1DM) and maturity onset diabetes of the young (MODY)], Group 2 [type 1 diabetes mellitus (T2DM)], and Group 3 [gestation diabetes mellitus (GDM)]. The primary study measurements included daily dose and percentage of different types of exogenous insulin requirements across gestation in different groups.ResultsInsulin total daily dosage of Group 1 was highest among the three groups and increased significantly from the first to the second/third trimester. Percentage of preprandial insulin increased from 53.8% (46.7, 60.0) and 54.5% (42.3, 62.9) in the first trimester to 63.6% (54.9, 75.0) and 67.2% (51.8, 73.7) in the second/third trimester in Group 1 and Group 2. All subjects with T1DM and 18.6% of subjects with T2DM still required insulin administration after delivery, with a 26.9% (19.0, 46.0) and 36.7% (26.9, 52.6) decrease in total insulin dose, respectively, whereas subjects with GDM and MODY weaned off insulin completely.ConclusionThe insulin requirements for pregnancy complicated with T1DM and MODY were higher than those for T2DM and GDM. In the subjects with PGDM, the insulin requirement and percentage of preprandial insulin increased gradually from early to mid- and late pregnancy.

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Section: Discussionmentioning

confidence: 99%

Comparison of insulin requirements across gestation in women with hyperglycemia in pregnancy: A prospective cohort study

Rao

Ping²

2022

Front. Endocrinol.

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“…Previous reviews have examined M-health in the context of all types of diabetes rather than a specific focus on gestational diabetes [228]. Leblalta et al addressed all digital health interventions available to support women with GDM including models of web-based care which have arguably become outdated [229].…”

Section: Introductionmentioning

confidence: 99%

Single site pilot clinical investigation of a novel app-assisted self-management programme for gestational diabetes

Smyth

Daly²,

Molphy³

et al. 2023

American Journal of Obstetrics and Gynecology

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“…Previous reviews have examined mHealth in the context of all types of diabetes rather than a specific focus on GDM [ 5 ]. Leblalta et al [ 6 ] addressed all digital health interventions available to support women with GDM, including models of web-based care that have arguably become outdated.…”

Section: Introductionmentioning

confidence: 99%

Smartphone Apps for Surveillance of Gestational Diabetes: Scoping Review

Smyth¹,

Curtin²,

Tully³

et al. 2022

JMIR Diabetes

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Background Developments and evolutions in the information and communication technology sector have provided a solid foundation for the emergence of mobile health (mHealth) in recent years. The cornerstone to management of gestational diabetes mellitus (GDM) is the self-management of glycemic indices, dietary intake, and lifestyle adaptations. Given this, it is readily adaptable to incorporation of remote monitoring strategies involving mHealth solutions. Objective We sought to examine and assess the available smartphone apps which enable self-monitoring and remote surveillance of GDM with a particular emphasis on the generation of individualized patient feedback. Methods Five databases were searched systematically for any studies evaluating mHealth-supported smartphone solutions for GDM management from study inception until January 2022. The studies were screened and assessed for eligibility of inclusion by 2 independent reviewers. Ultimately, 17 studies were included involving 1871 patients across 11 different countries. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) conceptual framework was adhered to for data extraction and categorization purposes. Results All studies analyzed as part of this review facilitated direct uploading of data from the handheld glucometer to the downloaded patient-facing smartphone app. Glycemic data were captured by all studies and were reassuringly found to be either improved or noninferior to extant models of hospital-based care. Feedback was delivered in either an automated fashion through in-app communication from the health care team or facilitated through bidirectional communication with the app and hospital portal. Although resource utilization and cost-effective analyses were reported in some studies, the results were disparate and require more robust analysis. Where patient and staff satisfaction levels were evaluated, the response was overwhelmingly positive for mHealth smartphone–delivered care strategies. Emergency cesarean section rates were reduced; however, elective cesarean sections were comparatively increased among studies where the mode of delivery was assessed. Most reviewed studies did not identify any differences in maternal, perinatal, or neonatal health when app-based care was compared with usual in-person review. Conclusions This comprehensive scoping review highlights the feasibility, reliability, and acceptability of app-assisted health care for the management of GDM. Although further exploration of the economic benefit is required prior to implementation in a real-world clinical setting, the prospect of smartphone-assisted health care for GDM is hugely promising

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Clinical Effectiveness of Different Technologies for Diabetes in Pregnancy: Systematic Literature Review

Cited by 11 publications

References 48 publications

Comparison of insulin requirements across gestation in women with hyperglycemia in pregnancy: A prospective cohort study

Comparison of insulin requirements across gestation in women with hyperglycemia in pregnancy: A prospective cohort study

Single site pilot clinical investigation of a novel app-assisted self-management programme for gestational diabetes

Smartphone Apps for Surveillance of Gestational Diabetes: Scoping Review

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