Digital clinical diagnostics and diabetes home testing provider Digostics has revealed the results from its gestational diabetes mellitus (GDM) remote screening collaboration with University Hospital Southampton NHS Foundation Trust (UHS), a partnership that saw expectant mothers in Hampshire become the first globally to access the oral glucose tolerance test (OGTT) without needing to attend clinic.
Digostics
The initiative, first announced in April 2023, saw women assessed as at risk of developing GDM by their midwife issued with a GTT@home test kit from Digostics to undertake their OGTT at home. The service’s introduction saw all women successfully tested in their target test week. Furthermore, 100% of mothers and maternity staff who responded to user surveys recommended GTT@home over traditional clinic-based testing.
The implementation of GTT@home stemmed from an ambition by UHS to improve the quality of the test and to test in a more patient-focused way, and to enable testing to be undertaken more quickly so that treatment can be initiated sooner where required. Objectives also included reducing the number of antenatal appointments required, freeing up valuable resources and improving healthcare equity of access, particularly for at-risk patient groups.
Improvements in test uptake, quality and reliability, earlier diagnoses, and user satisfaction levels, when combined with a significant reduction in OGTT management workload for maternity services, have seen the implementation meet or exceed all agreed success criteria.
Rachel Hanley, community service matron, UHS, said: “We are constantly trying to balance the critical importance of OGTT provision with the significant human resource and administrative demands in-clinic OGTTs place on us as a busy team. GTT@home has demonstrated that there is finally another way, one that not only helps ensure prompt and timely access to GDM testing, but that frees up countless valuable midwifery staffing hours to be redirected to other essential antenatal and postnatal activity.”
Up to 20% of UK pregnancies are impacted by GDM, with background risk factors including age, ethnicity and body mass index. Undiagnosed or untreated, GDM can lead to pregnancy complications that warrant unscheduled or even emergency changes to the birth-plan to protect both mother and baby. GDM also confers an increased risk for both mother and child of developing Type 2 diabetes later in life and accurate diagnosis with a reliable test is therefore important.
Prior to the implementation of GTT@home, undertaking an OGTT would require women to travel, while fasted, to a dedicated clinic on a specific date and spend over two hours at the hospital. The inconvenience the in-clinic test represents, especially for example for those with childcare pressures, means missed appointments and late tests are frequent. 97% of those using GTT@home found the ability to home test advantageous, with the same percentage welcoming the flexibility to choose which day they tested. 90% found the GTT@home test device easy to use, with no one finding it difficult to use.
Dr Matthew Coleman, consultant obstetric physician at UHS, said: “The contribution GTT@home has made to improving OGTT test patient empowerment, equity and accuracy will enable improved care for our patients when GDM is suspected and detected. In equal parts we are excited that this revolutionary new at-home test is going to dramatically change the way we deliver GDM testing during antenatal care.”
In a significant improvement from the in-clinic workflow, which typically sees blood samples only sent to the laboratory for analysis once the final test of the day has been completed, GTT@home ensures both blood tests associated with the OGTT – the initial fasting test and the two-hour test after consumption of a glucose drink – are analysed immediately at the point of testing. This eliminates the sample degradation that can occur between in-clinic blood sampling and laboratory analysis with the traditional OGTT.
After completing a test with GTT@home, the user can send their test data directly to their antenatal care team with a simple scan of a snap-off fob attached to the innovative test device using the GTT@home mobile app and the near field communication (NFC) functionality within their smartphone. Although users can send their test data via a prepaid envelope in the test kit, 98% elected to send their data via their smartphone, with their results available for review by their midwife much faster than could be achieved via the hospital laboratory.
Professor Richard Holt, professor in diabetes and endocrinology, University of Southampton, said: “UHS’ pilot implementation of GTT@home has shown that OGTT home testing is not just a viable alternative to in-clinic testing but a significantly more accessible way to screen women for diabetes and potentially improve test accuracy.
After the successful pilot of GTT@home at UHS, NHS trusts and health boards nationwide are looking to introduce GTT@home for their pregnant women in 2024. Digostics is also setting up operations in the Middle East and Asia Pacific to meet the significant demand for GTT@home in these regions and aims to expand to Europe and the USA.
James Jackson, CEO and founder of Digostics, said: “The results achieved by UHS in having the vision to eliminate barriers to effective GDM screening by taking diabetes testing directly to the mum-to-be speak for themselves. We congratulate our partners at UHS on the success of their GTT@home implementation and for breaking exciting new ground in both global diabetes innovation and women’s health.”
