Smartphone apps may improve gestational diabetes outcomes

The results of a systemic review found evidence potentially supporting the use of smartphone apps in mothers with gestational diabetes.

Mobile health apps (mHealth apps) can improve health-related outcomes, particularly blood sugar control, in patients with gestational diabetes (GD), according to a systematic review of the literature. The results were published in BMC Pregnancy and Childbirth, and the researchers noted that more detailed studies are warranted.

In 2019, about 20 million live births (16%) had some form of hyperglycemia during pregnancy, while about 84% of those mothers were diagnosed with MG, the authors wrote. Maternal age, obesity, and gestational weight gain are all risk factors for MG. The disease itself is associated with increased risks of preeclampsia, cesarean sections and other adverse outcomes of pregnancy and childbirth.

MHealth applications were introduced as early strategies to effectively improve GD management and “enable more specific and individual management of patient care,” according to the researchers.

To better understand the effectiveness of GD-specific mHealth applications on the health-related outcomes of these patients compared to control groups, researchers performed a systematic search of databases, including MedLine, Embase, and others. . A total of 6 studies were included in the final analysis; 408 MG patients used the apps (intervention group) while 405 controls did not.

Five studies were 2-arm randomized controlled trials and 1 was a controlled clinical trial. In addition, “4 of the studies indicated that the majority of their participants were in the third trimester of pregnancy (mean [SD] gestational age in intervention groups: 29.1 [1.9] weeks, 30.9 [3.6] weeks, 31.2 [4.1] weeks and n = 88 [76.4%] being between the 25th and the 32nd week of gestation) ”, wrote the authors.

The researchers found that people with MG who used the apps had tendencies to significantly improve fasting blood sugar, 2 h postprandial blood sugar, off-target blood glucose readings, mode of delivery (more vaginal births and less [emergency] cesarean sections) and patient compliance, compared to control patients.

In the intervention group, trends towards a lower birth rate and fewer incidents of macrosomia and hypoglycemia were observed, although the results were not statistically significant.

“Despite the limited data, the included studies indicated that GD-specific mHealth applications show a trend towards improved GD management,” the researchers said.

However, more information on fasting blood sugar and glycated hemoglobin is needed, as each of these parameters has only been studied in 1 or 2 studies in the review. To improve knowledge about the effectiveness of these applications, a standardized set of studied outcomes, in addition to nutritional and physical activity outcomes, would be beneficial, the authors noted.

The quality of 2 included studies was judged to be low, marking a limit to the review; the literature available on this topic was also limited, while the oldest included study was from 2016.

Based on the results, the researchers concluded that mHealth applications improve compliance, empower patients, and enable more intensive and closely monitored therapy. Overall, “despite the limited data, mHealth applications have shown potential to improve GD management”.

Reference

Eberle C, Loehnert M, and Stichling S. Effectiveness of specific mobile health applications (mHealth-apps) in gestational diabetes: a systematic review. BMC Pregnancy Childbirth. Published online December 5, 2021. doi: 10.1186 / s12884-021-04274-7


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