Abstract
Advice on dietary intake is an essential first line intervention for the management of gestational diabetes mellitus (GDM). Digital tools such as web-based and smartphone apps have been suggested to provide a novel way of providing information on diet for optimal glucose regulation in women with GDM. This systematic review explores the effectiveness and usability of digital tools designed to support dietary self-management of GDM. A systematic search of Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Scopus using key search terms identified 1476 papers reporting research studies, of which 16 met the specified inclusion criteria. The quality of the included studies was assessed using the ErasmusAGE Quality Score or the Mixed Methods Appraisal Tool (MMAT) version 2018. The findings show that the adoption of digital tools may be an effective approach to support self-management relating to healthy diet, health behaviour, and adherence to therapy in women with GDM as a usable intervention. However, there is a lack of evidence concerning the effectiveness of tools to support the dietary management of GDM. Consideration for ethnic specific dietary advice and evidence-based frameworks in the development of effective digital tools for dietary management of GDM should be considered as these aspects have been limited in the studies reviewed.
Highlights
Pregnant women with gestational diabetes mellitus (GDM) are at increased risk of adverse maternal and foetal outcomes [1,2]
Carral et al [38] (Spain) studies [27,31,34,39,40], women using the digital tool for dietary self-management had significantly lower glycaemic index, body mass index, gestational weight gain, and increased physical exercise compared with women in the control group
Based on findings of this review, digital tools to support lifestyle improvement relating to healthy diet, health behaviour, and adherence to therapy in women with GDM were found to be an acceptable and feasible intervention
Summary
Pregnant women with gestational diabetes mellitus (GDM) are at increased risk of adverse maternal and foetal outcomes [1,2]. GDM prevalence ranges between 1% and 28%, depending on population setting and diagnostic criteria used [3]. Management of GDM is aimed at achieving optimal glucose regulation through dietary and other lifestyle modifications, improvement of psychosocial care, and prevention of complications [6]. The ability of dietary interventions to be adapted and tailored to the needs of targeted populations make it an essential first line intervention for the lifestyle management of GDM [3]. A randomised trial found that a Mediterranean-style diet could be beneficial in reducing gestational weight gain and incidence of GDM in high risk pregnant women [9]. Appropriate dietary advice can support women with GDM to achieve improved dietary and other self-management approaches to GDM [10]
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