Affiliations: [a] University of Applied Sciences Western Switzerland, Institute of Business Information Systems, Sierre, Switzerland | [b] Department of Cardiology, University of Fribourg, Fribourg, Switzerland | [c] Hospital Riviera-Chablais, Bd Paderewski 3, 1800 Vevey, Switzerland
Abstract: Purpose:Gestational Diabetes Mellitus (GDM) is a condition affecting 3–4% of pregnant women due to increased resistance to insulin caused by the growth of the fetus. Such a condition disappears just after delivery, but it is an indicator of the insurgence of diabetes type 2 (DT2) later in life: about 40% of the women affected by GDM also develop DT2 [Diabetes Care 25(10) (2002), 1862–1868]. GDM brings several complications during pregnancy to both the mother and the fetus. The aim is to present a personal health system (PHS) for monitoring GDM and to present the results of outpatient monitoring and management by utilizing a PHS for GDM. Methods:The Personal Health System (PHS) was deployed in a feasibility study, modelled as a single-center, parallel group, open randomized controlled trial conducted in Lausanne University Hospital. Patients (n = 24) were assigned to 2 different groups: standard protocol group (SP) and telemedicine group (TM). SP patients were managed by regular clinic visits. TM patients were managed with our EPHS system. The targeted feasibility outcome was whole trial feasibility, functioning of the PHS and its appropriateness for patient use. Results:Mean age was 32 ± 5 years and patients were pregnant for 29.1 ± 1.9 weeks at study inclusion. Patients came from 16 different countries. The follow-up rate was 100%. Acceptability in the TM-group was high, as 100% were satisfied with the care provided and equally 100% were at ease with the technology. Overall median[IQR] glucose control was 5.4 mmol/l [4.7–6.4] in the TM-group and 5.7 mmol/l [4.9–6.7] in the SP-group (p < 0.001). Four out of 6 daily plasma glucose values were significantly better controlled with telemedicine compared to standard care. Conclusion:The feasibility study that was conducted shows that PHSs have a great potential to improve the life of the patient by allowing a better communication of their physiological values to the caregivers. With respect to the particular case of GDM, the study suggests that use of PHS technology may improve glycaemic control in GDM, but to confirm this trend, a main trial is needed.
Keywords: Personal Health Systems, Gestational Diabetes Mellitus, diabetes, expert systems, agents, telemedicine
