Pregnant women in Southampton are set to be the first in the world to access remote-testing technology that enables screening for gestational diabetes mellitus (GDM) at home rather than in a clinic. The test would replace oral glucose tolerance tests (OGTT), which are currently offered only in clinic.
Expectant mothers under the care of University Hospital Southampton (UHS) NHS Foundation Trust maternity services are to be offered the opportunity to take part in the "ground-breaking new project in diabetes detection".
Announcing the pilot trial of the new programme, UHS in partnership with Oxfordshire-based digital diagnostics manufacturer Digostics, said: "In taking the oral glucose tolerance test (OGTT) to the patient, UHS aim to improve diabetes screening and healthcare equity of access by identifying the presence of GDM earlier in the pregnancy and eliminating barriers commonly associated with in-clinic testing."
Undetected Diabetes can Cause Maternal and Foetal Complications
The team noted that GDM impacts up to 20% of UK pregnancies. Left undiagnosed or untreated, GDM can contribute to perinatal complications such as foetal macrosomia, which according to the NHS increases the risks of needing labour induction or Caesarean delivery.
Other potential complications include polyhydramnios, premature labour, pre-eclampsia, neonatal jaundice, and, rarely, stillbirth. Half of all affected mothers develop full-blown type 2 diabetes (T2D) within 10 years, and their infants have an eightfold increase in risk of developing T2D in adulthood.
"Prompt identification of GDM is key," the team said, but oral glucose tolerance tests (OGTT) are currently offered only in clinic and "take the best part of a morning to complete". The inconvenience of this for patients and the provisioning challenges posed for healthcare providers frequently constrain test throughput, which "can lead to delayed testing".
The diabetes home-testing solution, GTT@home, developed by Digostics, is currently the only regulatory-approved home-use OGTT. It combines new testing technologies and near-field communication wireless functionality that enables test data to be sent immediately to the care team via a smartphone.
The kit, which is mailed to the expecting mother so she can test on a day of her choosing, contains a novel test device, a glucose drink, and finger prickers. Online guidance and telephone support are available. To deliver the results, the woman can either scan a snap-off fob attached to the test device with a smartphone using a mobile app - a process akin to making a contactless mobile payment in a store – or mail back the fob in a supplied prepaid envelope for processing. An associated software platform enables the antenatal team to schedule tests and view patient results.
Earlier, Faster Testing Could Transform Diabetes Screening
The advance should lead to earlier testing, faster return of results, with prompt treatment and management where GDM is detected, the team said. "In addition to making a real impact in a critical area of women's health, the ability to offer home-testing has the potential to transform how all forms of diabetes are screened."
Project Leader Dr Matthew Coleman, consultant obstetrician at UHS, said: "We hope this revolutionary new at-home test is going to dramatically change the way we deliver gestational diabetes testing during antenatal care.
"Not only is it better for the patients to self-test in the convenience of their own home, cutting down the number of antenatal appointments they attend, but it will also free up precious NHS time and resources."
He added: "From the admin resources it takes to book and manage clinics, the clinical time taken to run the service and the clinic space taken, this can all now be done with a simple test at home using the GTT@home kit."