Remote blood glucose monitoring
Topic Status Complete
Remote monitoring of blood glucose in women with gestational diabetes.
Outcome of the appraisal
HTW undertook an evidence review to address the following question: what is the clinical and cost effectiveness of remotely monitoring blood glucose compared to usual (clinic-based) care in women with gestational diabetes?
The HTW Assessment Group concluded that there is currently insufficient evidence on remote blood glucose monitoring to inform the production of Guidance at this time. Therefore, this topic will not progress to Appraisal Panel and will not receive HTW Guidance recommendations.
Evidence Appraisal Report 018 gives a full report of the evidence on this topic.
Why was this topic appraised?
Gestational diabetes is a type of diabetes that is diagnosed during pregnancy and increases the risk of morbidity and mortality during pregnancy. Monitoring blood glucose helps to control blood glucose levels and minimise risks to the mother and baby. Blood glucose monitoring usually involves the woman self-monitoring at home using a blood glucose meter (‘finger-prick test’) and recording results in a diary or logbook. Remote blood glucose monitoring technologies automatically collect blood glucose readings from the pregnant woman’s blood glucose meter at home and sends this information to a healthcare professional for review.
Plain language summary
Health Technology Wales (HTW) looked for evidence to see if remote monitoring of blood glucose (RMBG) is an effective way for women with gestational diabetes to control their blood sugar (or glucose) levels. Gestational diabetes is a type of diabetes that is diagnosed during pregnancy, where the women did not previously have diabetes. Women who suffer from gestational diabetes face an increased risk of developing complications and illnesses for themselves and their baby than women who do not have gestational diabetes. Being able to monitor blood sugar levels in real time and plan accordingly can help to reduce these risks. The most common method of measuring blood sugar is to have women take measurements themselves using a blood glucose meter (known as the finger-prick method) and record their levels in a diary. RMBG is an alternative method to the finger-prick method. This type of technology automatically takes blood sugar levels from a reader and transmits these to health care professionals to review.
The evidence found suggests that using RMBG or the finger-prick method results in similar pregnancy outcomes for both mother and baby. Some evidence suggests that it RBMG could reduce the risk of women needing a caesarean section birth and the risk of having a pre-term birth, but this evidence is not always consistent. Patient evidence suggests that successful use of RMBG technology depends on a number of social, behavioural and educational factors. Where patients are able to successfully use this technology, satisfaction was high. The economic evidence did not show a significant different in costs per birth when compared to other methods and there was no evidence to suggest that it helped to reduce the number of times women needed to attend clinic appointments during pregnancy, so it is unclear what the overall economic impact of this technology would be. Because of this uncertainty, HTW will not be producing guidance on the use of this technology at this present time.