Table 2.

Characteristics of studies evaluating smartphone app–assisted care for GDM and the provision of remote feedback.

Article information	Type of trial	Participants, n	GDMa diagnosis	Glycemic targets	Self-monitoring schedule	Details of smartphone app–assisted technology
Calle-Pascual et al, Spain (2010) [8]	Prospective randomized interventional study	100	Carpenter Couston criteria; <28 weeks’ gestation	Fasting <95 mg/dl; 1-h postprandial <120 mg/dl	6× a day	Infrared enabled transfer of SMBGb from glucometer to smartphone app (preinstalled), with captured data then transferred to a central hospital database (Emminens Conecta Plus Web Application); bidirectional communication between patient and HCPc
MacKillop et al, UK (2018) [9]	Randomized controlled trial	206	Fasting >5.6 mmol/l; postprandial >7.8 mmol/l <35 weeks’ gestation	Fasting <5.3 mmol/l; 1-h postprandial; 7.8 mmol/l; 2-h postprandial <6.4 mmol/l	6× a day, 3 days a week	Bluetooth-enabled transfer of SMBG from glucometer to smartphone app (GDm-Health), with captured data transferred to a secure website. Review of website 3 × a week by the specialist midwife; unidirectional communication of staff to patient only
Guo et al, China (2018) [10]	Randomized interventional study	124	IADPSGd criteria; 24-28 weeks’ gestation	Unspecified	6× a day, 3 days a week reducing to 2 days a week if control demonstrated	Automatic data upload from glucometer to app (Dnurse); HCP review of uploaded data from app to doctor-facing version of Dnurse; HCP able to communicate with patient to adapt medical guidance; unidirectional communication of staff to patient only
Al-ofi et al, Saudi Arabia (2019) [11]	Randomized open-label control study	60	IADPSG criteria; 24-28 weeks’ gestation	Fasting <5.1 mmol/l; postprandial <8.5 mmol/l	4× a day	Glucometer linked to smartphone app (Glucomail) enabling easy transfer of data to the app, with captured data then transferred to a secure hospital-based system; an immediate alert is generated to the HCP if above-threshold levels are recorded, allowing for further action to be taken; unidirectional communication of staff to patient only
Yew at al, Singapore (2021) [12]	Randomized controlled trial	340	WHOe 2013 criteria (endorsed IADPSG criteria); 12-30 weeks’ gestation	Fasting <5.5 mmol/l; 2-h postprandial <6.6 mmol/l	7× a day, 2-3 times a week	Smartphone-based lifestyle coaching program associated with a secure web app (Habits-GDM); app-compatible glucometer to transfer SMBG values; bidirectional communication between patients and HCP
Borgen et al, Norway (2019) [13]	Randomized controlled trial	238	2-h OGTTf >9 mmol/l; <33 weeks’ gestation	Unspecified	Unspecified	Bluetooth-enabled transfer of SMBG values from glucometer to app (Pregnant+); automated color-coded feedback in direct response to glycemic control; no in-app communication between patient and HCP
Sung et al, South Korea (2019) [14]	Randomized controlled trial	21	2-step approach IADPSG criteria or Carpenter Couston criteria; <30 weeks’ gestation	Unspecified	4× a day	Bluetooth-enabled transfer of SMBG values from glucometer to smartphone app; automatic transfer of data by a wireless network captured in the app to a secure server; bidirectional communication between HCP and patient; HCP sends tailored medical and nutritional guidance from the server to the app
Miremberg et al, United States (2018) [15]	Randomized controlled trial	120	2-step process Carpenter Couston criteria; <34 weeks’ gestation	Fasting <95 g/dL; 1-h postprandial <140 g/dL	4× a day	Delivery of personalized feedback from the HCP secure database to the patient’s app (Glucose Buddy) regarding self-management, glycemic control, and follow-up scheduling; bidirectional communication between the HCP and the patient.
Poulter et al, Australia (2021) [16]	Intervention study	100	IADPSG criteria; 24-30 weeks’ gestation	Fasting <5 mmol/l; postprandial <6.7 mmol/l	4× a day	Bluetooth-enabled glucometer to upload SMBG data to the app (NET Health) which are automatically sent to a secure central server, with the software server automatically flagging the above-threshold glycemic values; unidirectional communication of the HCP to patients through the in-app interface
Rigla et al, Spain (2018) [17]	Pilot study	20	NDDGg criteria; <34 weeks’ gestation	Unspecified	4× a day	Bluetooth-enabled glucometer facilitating transfer of SMBG to the app (MobiGuide) with subsequent transfer of the data to a specifically designed decision support software, with the HCP using a web-based app to visualize all the patient data; no feedback between staff and patients through the app/server system
Varnfield et al, Australia (2021) [18]	Feasibility study	40	IADPSG criteria; 24-28 weeks’ gestation; (if RFh at earlier OGTT in T1, with repeat at 24-28 weeks if normal)	Fasting <5 mmol/l; - h postprandial <7.4 mmol/l; 2-h postprandial <6.7 mmol/l	4× a day	Bluetooth enabled glucometer facilitating transfer of SMBG values to the app (MoTHER); automatic transmission of app data to the clinician web portal which is reviewed weekly by the HCP; no in-app communication between HCP and patients
Khalil et al, France (2019) [19]	Qualitative study	15	Unspecified	Unspecified	6× a day reducing to 3 × a day if stable BGLi	Bluetooth-enabled glucometer to facilitate transfer of SMBG to the app (MyDiabby); color-coded (green, orange, red) automated feedback reflecting glycemic control and customized alert system at the server/HCP end of the solution; bidirectional communication between HCP and patients
Moazen et al, Austria (2021) [20]	Pilot study	27	Unspecified	Unspecified	4× a day	Bluetooth-enabled glucometer to facilitate transfer of SMBG to the app (DiabCare); data are transferred from the app to an online data management system accessible by the health care team; bidirectional communication between HCP and patients.
Seo et al, South Korea (2020) [21]	Case series study	4	Diagnosed following OGTT at 24-28 weeks’ gestation	Unspecified	Unspecified	Bluetooth-enabled glucometer to facilitate transfer of SMBG to the app; transfer of data captured by the app via wireless network to the study server; personalized and automated feedback; bidirectional communication between HCP and patients
Wickramasinghe et al, Australia (2019) [22]	Randomized crossover study	10	Diagnosed following OGTT at 26-28 weeks’ gestation	Unspecified	4× a day	Bluetooth-enabled glucometer to facilitate transfer of SMBG to the app (Diamond solution); data captured by the app are reviewed on a secure platform by the HCP who responds to the patient with recommendations; unidirectional communication of the HCP to patient through the in-app interface
Yang et al, China (2018) [23]	Pilot intervention study	157	WHO 2013 criteria (endorsed IADPSG criteria)	Fasting <5.3 mmol/l; 1-h postprandial <7.8 mmol/l; 2-h postprandial <6.7 mmol/l	10× a day	Smartphone app using a WeChat system to which blood glucose, blood pressure, and weight are uploaded; data are subsequently uploaded to a cloud platform and are evaluated by the HCP through the HCP’s own WeChat interface; unidirectional communication of HCP to patient through the WeChat system
Tian et al, China (2020) [24]	Randomized controlled trial	309	IADPSG criteria; <31 weeks’ gestation	Fasting <5.3 mmol/l; 1-h postprandial <7.8 mmol/l; 2-h postprandial <6.7 mmol/l	5× a day for 6 days in a 2-week block	Smartphone app using a WeChat system to which blood glucose, diet, exercise and weight are uploaded; unidirectional communication of HCP to patient only; peer-to-peer communication

^aGDM: gestational diabetes mellitus.

^bSMBG: self-monitored blood glucose

^cHCP: health care provider.

^dIADPSG: International Association of Diabetes in Pregnancy Study Group.

^eWHO: World Health Organization.

^fOGTT: oral glucose tolerance test.

^gNDDG: National Diabetes Data Group.

^hRF: risk factors.

ⁱBGL: blood glucose level.