Impact of the use of a smartphone-based blood glucose management system within a maternal diabetes service

Background: The incidence of gestational diabetes mellitus is increasing, placing more demand on pregnancy diabetes services. Aims: This study aimed to explore the impact of implementing GDm-Health, a remote blood glucose monitoring application (app), on a tertiary pregnancy diabetes service. Methods: This retrospective cohort study was conducted as part of a quality improvement project. We assessed the frequency of interactions between patients and health care professionals, the type of interactions (face-to-face [f2f] or non-f2f [via text or phone call]), effect on time to treatment initiation and women's satisfaction with the app. We compared two cohorts: cohort 1, women diagnosed in September 2019 (n=52) prior to app introduction, and cohort 2, women diagnosed in September 2020 (n=54) after app introduction. Data were collected from the electronic notes, and app satisfaction was assessed using a questionnaire. Results: Median interactions for each woman from diagnosis to delivery increased from 5 (interquartile range [IQR], 3-6) in cohort 1 to 7 (IQR, 5-10) in cohort 2 (p<0.001). In cohort 2, 88.4% of interactions were non-f2f compared to 13.7% in cohort 1. There was no change in the time to treatment initiation (19 days [cohort 1] vs 20 days [cohort 2]; p=0.59). Women using the app were satisfied with their care. Conclusions: After GDm-Health was introduced, women had more interactions with the diabetes team; however, most were non-f2f interactions via telephone. The app has helped health care professionals streamline the service, particularly in terms of the allocation of clinic space and appointments, and has been well received by patients.