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other·obstetrics and gynecology, endocrinology, internal medicine, clinical trial, research methods·PMC10646680

Supporting the Management of Gestational Diabetes Mellitus With Comprehensive Self-Tracking: Mixed Methods Study of Wearable Sensors

JMIR Diabetes · 8 authors, 7 centres

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TL;DR

This mixed methods study explored the use of wearable sensors for self-management of gestational diabetes mellitus in 10 women.

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This mixed methods study investigated how to support self-management of gestational diabetes mellitus (GDM) using wearable sensors. Data were collected from sensors, followed by semistructured interviews and UTAUT acceptability questionnaires. Results indicated the continuous glucose monitor was the most useful sensor for self-discovery, particularly for learning associations between glucose and nutrition intake. High acceptance for wearable sensors was reported.

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other

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obstetrics and gynecology

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ORIGINAL PAPER

PMC10646680

Supporting the Management of Gestational Diabetes Mellitus With Comprehensive Self-Tracking: Mixed Methods Study of Wearable Sensors

JMIR Diabetes

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ABSTRACT

Background Gestational diabetes mellitus (GDM) is an increasing health risk for pregnant women as well as their children. Telehealth interventions targeted at the management of GDM have been shown to be effective, but they still require health care professionals for providing guidance and feedback. Feedback from wearable sensors has been suggested to support the self-management of GDM, but it is unknown how self-tracking should be designed in clinical care. Objective This study aimed to investigate how to support the self-management of GDM with self-tracking of continuous blood glucose and lifestyle factors without help from health care personnel. We examined comprehensive self-tracking from self-discovery (ie, learning associations between glucose levels and lifestyle) and user experience perspectives. Methods We conducted a mixed methods study where women with GDM (N=10) used a continuous glucose monitor (CGM; Medtronic Guardian) and 3 physical activity sensors: activity bracelet (Garmin Vivosmart 3), hip-worn sensor (UKK Exsed), and electrocardiography sensor (Firstbeat 2) for a week. We collected data from the sensors, and after use, participants took part in semistructured interviews about the wearable sensors. Acceptability of the wearable sensors was evaluated with the Unified Theory of Acceptance and Use of Technology (UTAUT) questionnaire. Moreover, maternal nutrition data were collected with a 3-day food diary, and self-reported physical activity data were collected with a logbook. Results We found that the CGM was the most useful sensor for the self-discovery process, especially when learning associations between glucose and nutrition intake. We identified new challenges for using data from the CGM and physical activity sensors in supporting self-discovery in GDM. These challenges included (1) dispersion of glucose and physical activity data in separate applications, (2) absence of important trackable features like amount of light physical activity and physical activities other than walking, (3) discrepancy in the data between different wearable physical activity sensors and between CGMs and capillary glucose meters, and (4) discrepancy in perceived and measured quantification of physical activity. We found the body placement of sensors to be a key factor in measurement quality and preference, and ultimately a challenge for collecting data. For example, a wrist-worn sensor was used for longer compared with a hip-worn sensor. In general, there was a high acceptance for wearable sensors. Conclusions A mobile app that combines glucose, nutrition, and physical activity data in a single view is needed to support self-discovery. The design should support tracking features that are important for women with GDM (such as light physical activity), and data for each feature should originate from a single sensor to avoid discrepancy and redundancy. Future work with a larger sample should involve evaluation of the effects of such a mobile app on clinical outcomes. Trial Registration Clinicaltrials.gov NCT03941652; https://clinicaltrials.gov/study/NCT03941652

CITATION EXPORT

Mikko Kytö, Saila Koivusalo, Heli Tuomonen et al.. Supporting the Management of Gestational Diabetes Mellitus With Comprehensive Self-Tracking: Mixed Methods Study of Wearable Sensors. JMIR Diabetes. (2023). https://doi.org/10.2196/43979

AUTHORS

8 · 7 CENTRES

Mikko Kytö, Saila Koivusalo, Heli Tuomonen, Lisbeth Strömberg, Antti Ruonala, Pekka Marttinen, Seppo Heinonen, Giulio Jacucci

1 Helsinki University Hospital IT Management Helsinki University Hospital Helsinki Finland
2 Department of Computer Science University of Helsinki Helsinki Finland
3 Department of Gynecology and Obstetrics Turku University Hospital Turku Finland
4 Department of Gynecology and Obstetrics University of Turku Turku Finland
5 Department of Gynecology and Obstetrics Helsinki University Hospital Helsinki Finland
6 Department of Gynecology and Obstetrics University of Helsinki Helsinki Finland
7 Department of Computer Science Aalto University Espoo Finland

EDITOR / REVIEWER

Kara Mizokami-Stout, Hossein Motahari-Nezhad, Amit Majithia, Kimberly Tufts, Katie Wynne