Development of a real-time smartphone solution for the management of women with or at high risk of gestational diabetes.
Development of a real-time smartphone solution for the management of women with or at high risk of gestational diabetes.
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DOI：
10.1177/1932296814542271
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发表时间：
2014-11-01
影响因子：
5
通讯作者：
Tarassenko, Lionel
中科院分区：
文献类型：
--
作者：
Mackillop, Lucy;Loerup, Lise;Tarassenko, Lionel
妊娠期糖尿病（GDM）是指妊娠期新发或确认的糖耐量异常。证据支持严格的血糖调节，以防止不良的母亲和胎儿的结果。手指点刺血糖（BG）测试与频繁的临床审查仍然是最常见的方法管理糖尿病在怀孕期间。GDM的发病率在全球范围内不断上升，给资源有限的服务带来了压力。我们开发了一个直观、互动、可靠和准确的管理系统，用于记录血糖测量值并远程管理GDM。在初始范围确定阶段之后，使用Android智能手机开发了原型软件应用程序，通过蓝牙连接血糖仪。建立了一个自定义网站，供临床医生查看智能手机传输的数据。系统完善后，进一步评估的可用性和可靠性进行了48名病人的服务开发项目。女性平均使用该系统13.1周。总共传输了19686个BG测量值，其中98.6%有餐标。共发送了466条短信。每周平均传输30个BG读数，85%的女性提交了每周18个读数的最低要求。我们开发了一种新型的、实时的、基于智能手机的血糖监测管理系统，该系统允许临床医生查看实时患者注释的血糖结果。结果表明，妇女使用率高，依从性好。需要进行稳健的临床、经济和满意度评估。为了满足这些要求，我们目前正在进行一项随机对照试验。
Gestational diabetes mellitus (GDM) is defined as new onset or recognition of glucose intolerance in pregnancy. Evidence supports tight blood glucose regulation to prevent adverse maternal and fetal outcomes. Finger-prick blood glucose (BG) testing with frequent clinic review remains the most common method of managing diabetes in pregnancy. The prevalence of GDM is rising globally, pressuring resource-limited services. We have developed an intuitive, interactive, reliable, and accurate management system to record BG measurements and deliver management of GDM remotely. Following an initial scoping phase, a prototype software application was developed using an Android smartphone with BG meter linkage via Bluetooth. A custom website was built for clinician review of the data transmitted by the smartphone. After system refinement, further evaluation was undertaken for usability and reliability in a 48-patient service development project. Women used the system for an average of 13.1 weeks. In all, 19 686 BG measures were transmitted, 98.6% of which had a meal tag. A total of 466 text messages were transmitted. A mean of 30 BG readings per woman per week were transmitted, and 85% of women submitted the minimum requirement of 18 readings per week. We have developed a novel, real-time, smartphone-based BG monitoring management system that allows clinician review of real-time patient-annotated BG results. Results indicate high usage and excellent compliance by women. Robust clinical, economic, and satisfaction evaluations are required. To address these requirements, we are currently conducting a randomized controlled pilot trial.