Table 3.
Overview of randomised controlled trials reporting on the effectiveness of digital tools to support dietary self-management of GDM.
| Author (Country) | Aim of the Study | Participants, Setting | Study Intervention | Key Findings |
|---|---|---|---|---|
| Borgen et al. [41] (Norway) |
To assess the effectiveness of a “pregnancy+ “app on Glu levels |
238 women, 5 diabetes clinics |
Intervention (N = 115): pregnancy+ app and usual care Control (N = 123): usual care |
NS difference in Glu levels [6.7 mmol/L (95% CI 6.2 to 7.1) vs. 6.0 mmol/L (95% CI 5.6 to 6.3)] intervention vs. control |
| Caballero-Ruiz et al. [40] (Spain) |
To evaluate the effectiveness of a web-based support system (Sinedie) on diabetes clinic visits |
90 pregnant women with GDM, diabetes clinic | Intervention (N = 60): Web-based support system and standard care Control (N = 30): Standard care |
Diabetes clinic visits reduced by 88.6% |
| Carral et al. [38] (Spain) |
To assess the effects of a web-based telemedicine system on diabetes clinic visits, monitoring Glu control, maternal, and neonatal outcomes | 104 pregnant women, diabetes clinic | (GDM = 77, T1DM = 16, T2DM = 11). Intervention (N = 40): Telemedicine and standard care Control (N = 64): Standard care |
Diabetes clinic visits reduced (3.2 ± 2.3 vs. 5.9 ± 2.3 visits; p < 0.001) intervention vs. Control NS difference in maternal outcomes: CS prevalence (30% vs. 40%; p = 0.164), MWG (8.4 kg ± 6.5 kg vs. 9.0 kg ± 6.6 kg; p = 0.644) intervention vs. control NS difference in neonatal outcomes: LGA prevalence hypoglycaemia (2.5% vs. 3.1%) intervention vs. control |
| Carolan-Olah and Sayakhot [39] (Australia) |
To investigate the effects of an online educational programme on maternal BMI, blood pressure, glycaemic index, and infant birthweight | 110 women with GDM, diabetes clinic | Intervention (N = 52): Web-based education and standard care Control group (N = 58): Standard car |
44.2% women in intervention group maintained normal BMI (18.5–24.9 kg/m2 post intervention (vs 31%, p < 0.001) intervention vs. control Maternal BP * (107/64 mm Hg vs. 109/66 mm Hg), ** (108/68 mm Hg vs. 112/68 mm Hg)] intervention vs. control, NS difference Maternal Glu [(8.8 mmol/L * and 7.3 mmol/L **) vs. (4.9 mmol/L * and 4.7 mmol/L **)] intervention vs. control NBW 2.5 kg−4 kg, NS (92.3% vs. 94.8%) intervention vs. control |
| Dalfrà et al. [37] (Italy) |
To assess the effect of a telemedicine system on maternal and foetal outcome in women with GDM | 276 pregnant women attending a diabetes clinic (GDM = 240, T1DM = 36) | Pregnant women with GDM -Intervention (N = 88) (Standard care and Telemedicine) -Control (N = 115): Standard care Pregnant women with TIDM -Intervention (N = 17): Telemedicine and standard care -Control (N = 15): Standard care |
NS difference in CS and FM (p = 0.02) |
| Guo et al. [34] (China) |
To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood Glu control, and pregnancy outcomes | 124 women with GDM, diabetes clinic | Intervention (N = 64): Mobile medical management and standard care Control (N = 60): standard care |
Significant effect on blood Glu control (4.7 ± 0.2 vs. 5.3 ± 0.3 p < 0.001) and MWG, (3.2 ± 0.8 vs. 4.8 ± 0.7, p < 0.001) Intervention vs. control NS on pregnancy outcomes: CS (33.3% vs. 25.0%, p = 0.325), FM (10% vs. 65.3%, p = 0.295) intervention vs. control |
| Kennelly et al. [31] (Ireland) |
To investigate the effect of a smartphone-supported behavioural intervention on the incidence of GDM in overweight and obese women | 565 obese women with GDM, diabetes clinic | Intervention (N = 278): Smartphone-supported intervention and standard care Control (N = 287l): standard care |
NS difference in incidence of GDM (15.4% vs. 14.1%, p = 0.71) intervention vs. control |
| Roozbahani et al. [28] (Iran) |
To investigate the effects of telephone follow-up on blood glucose level during pregnancy and postpartum screening in women with GDM | 80 women with GDM, diabetes clinic | Intervention (N = 40): 10 weeks telephone follow-up Control (N = 40): 3 weeks telephone follow-up |
NS in Glu level at 28 weeks of pregnancy (122.5 ± 19.7 mg/dL vs. 113.2 ± 15.8 mg/dL, p = 0.06) intervention vs. control |
| Miremberg et al. [30] (Israel) |
To explore the impact of a smartphone-supported intervention, on patient compliance, glycaemic control, pregnancy outcome, and patient satisfaction | 120 newly diagnosed women with GDM, diabetic clinic | Intervention (N = 60): Smartphone-supported intervention and standard care Control (N = 60): Standard care |
NS difference in LC (84 ± 0.16% vs. 66 ± 0.28%, p < 0.001) and Mean Glu (105.1 ± 8.6 mg/dL vs. 112.6 ± 7.4 mg/dL, p < 0.001) intervention vs. control, |
* Pre-intervention, ** Post-intervention. Abbreviations: BP = Blood pressure, BMI = Body mass index, CS = Caesarean section, FM = Foetal macrosomia, GDM = Gestational diabetes mellitus, Glu = Glucose, Large for gestational age, LC = Level of compliance = Maternal weight gain, NBW = Neonatal birth weight, NS = Not significant.