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Poster Session 3

(685) Smartphone application use for gestational diabetes management and immediate postpartum glucose tolerance outcomes

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: Use of smartphone applications for gestational diabetes (GDM) management has increased in recent years, but their effect on maternal postpartum glucose tolerance is unknown. This pilot randomized controlled trial investigated the effect of the Malama smartphone application, a glucose monitoring and interactive diet education tool, on early postpartum glucose tolerance and perinatal outcomes.

Study Design: Patients with GDM receiving prenatal care at an urban academic medical center were randomized 1:1 to Malama application use compared to standard care. The primary outcome was 2 hour oral glucose tolerance test (OGTT) level measured during the delivery hospitalization. Secondary outcomes included patient satisfaction, postpartum hemoglobin A1c (HbA1c), delivery outcomes, and perinatal morbidity.   

Results: Twenty-eight participants were randomized (14 participants per group). Malama users had lower median 2 hour OGTT levels compared to patients receiving standard care (120 vs 155 mg/dL; P=.05; incident rate ratio, 0.78 [95% CI 0.61-0.99]). There were no differences in postpartum HbA1c, mode of delivery, birthweight, or other perinatal outcomes. Patient satisfaction with glucose logging methods was equivalent between groups.  When the groups’ baseline characteristics were compared, Malama users were younger than those receiving standard care (30.9±4.1 vs 36.4±3.8 years; p=.001), while other characteristics were similar between groups. After adjusting for maternal age, the difference in 2 hour OGTT was no longer significant (adjusted incident rate ratio, 0.92 [95% CI 0.69-1.23]). 

Conclusion: Compared with standard glucose logging methods, Malama application use was acceptable to patients with GDM and was associated with improved early postpartum glucose tolerance values in the unadjusted model, but not after adjusting for differences in age. Larger studies are needed, stratifying by age, to fully evaluate the impact of smartphone applications on postpartum glucose and perinatal outcomes.