Browsing by Author "Koivusalo, Saila B."

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Comprehensive self-tracking of blood glucose and lifestyle with a mobile application in the management of gestational diabetes: a study protocol for a randomised controlled trial (eMOM GDM study)
(2022-11-07) Kytö, Mikko; Markussen, Lisa Torsdatter; Marttinen, Pekka; Jacucci, Giulio; Niinistö, Sari; Virtanen, Suvi M.; Korhonen, Tuuli E.; Sievänen, Harri; Vähä-Ypyä, Henri; Korhonen, Ilkka; Heinonen, Seppo; Koivusalo, Saila B.
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Introduction Gestational diabetes (GDM) causes various adverse short-term and long-term consequences for the mother and child, and its incidence is increasing globally. So far, the most promising digital health interventions for GDM management have involved healthcare professionals to provide guidance and feedback. The principal aim of this study is to evaluate the effects of comprehensive and real-time self-tracking with eMOM GDM mobile application (app) on glucose levels in women with GDM, and more broadly, on different other maternal and neonatal outcomes. Methods and analysis This randomised controlled trial is carried out in Helsinki metropolitan area. We randomise 200 pregnant women with GDM into the intervention and the control group at gestational week (GW) 24-28 (baseline, BL). The intervention group receives standard antenatal care and the eMOM GDM app, while the control group will receive only standard care. Participants in the intervention group use the eMOM GDM app with continuous glucose metre (CGM) and activity bracelet for 1 week every month until delivery and an electronic 3-day food record every month until delivery. The follow-up visit after intervention takes place 3 months post partum for both groups. Data are collected by laboratory blood tests, clinical measurements, capillary glucose measures, wearable sensors, air displacement plethysmography and digital questionnaires. The primary outcome is fasting plasma glucose change from BL to GW 35-37. Secondary outcomes include, for example, self-tracked capillary fasting and postprandial glucose measures, change in gestational weight gain, change in nutrition quality, change in physical activity, medication use due to GDM, birth weight and fat percentage of the child. Ethics and dissemination The study has been approved by Ethics Committee of the Helsinki and Uusimaa Hospital District. The results will be presented in peer-reviewed journals and at conferences. Trial registration number NCT04714762.
Periodic mobile application (eMOM) with self-tracking of glucose and lifestyle improves treatment of diet-controlled gestational diabetes without human guidance : a randomized controlled trial
(2024-11) Kytö, Mikko; Hotta, Shinji; Niinistö, Sari; Marttinen, Pekka; Korhonen, Tuuli E.; Markussen, Lisa T.; Jacucci, Giulio; Sievänen, Harri; Vähä-Ypyä, Henri; Korhonen, Ilkka; Virtanen, Suvi; Heihonen, Seppo; Koivusalo, Saila B.
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Background: Digitalization with minimal human resources could support self-management among women with gestational diabetes and improve maternal and neonatal outcomes. Objective: This study aimed to investigate if a periodic mobile application (eMOM) with wearable sensors improves maternal and neonatal outcomes among women with diet-controlled gestational diabetes without additional guidance from healthcare personnel. Study Design: Women with gestational diabetes were randomly assigned in a 1:1 ratio at 24 to 28 weeks’ gestation to the intervention or the control arm. The intervention arm received standard care in combination with use of the periodic eMOM, whereas the control arm received only standard care. The intervention arm used eMOM with a continuous glucose monitor, an activity tracker, and a food diary 1 week/month until delivery. The primary outcome was the change in fasting plasma glucose from baseline to 35 to 37 weeks’ gestation. Secondary outcomes included capillary glucose, weight gain, nutrition, physical activity, pregnancy complications, and neonatal outcomes, such as macrosomia. Results: In total, 148 women (76 in the intervention arm, 72 in the control arm; average age, 34.1±4.0 years; body mass index, 27.1±5.0 kg/m2) were randomized. The intervention arm showed a lower mean change in fasting plasma glucose than the control arm (difference, −0.15 mmol/L vs −2.7 mg/mL; P=.022) and lower capillary fasting glucose levels (difference, −0.04 mmol/L vs −0.7 mg/mL; P=.002). The intervention arm also increased their intake of vegetables (difference, 11.8 g/MJ; P=.043), decreased their sedentary behavior (difference, −27.3 min/d; P=.043), and increased light physical activity (difference, 22.8 min/d; P=.009) when compared with the control arm. In addition, gestational weight gain was lower (difference, −1.3 kg; P=.015), and there were less newborns with macrosomia in the intervention arm (difference, −13.1 %; P=.036). Adherence to eMOM was high (daily use >90%), and the usage correlated with lower maternal fasting (P=.0006) and postprandial glucose levels (P=.017), weight gain (P=.028), intake of energy (P=.021) and carbohydrates (P=.003), and longer duration of the daily physical activity (P=.0006). There were no significant between-arm differences in terms of pregnancy complications. Conclusion: Self-tracking of lifestyle factors and glucose levels without additional guidance improves self-management and the treatment of gestational diabetes, which also benefits newborns. The results of this study support the use of digital self-management and education tools in maternity care.