Velmio
 
You've probably heard of diabetes and perhaps you even know the difference between type 1 and type 2 diabetes. Yet many people are not aware that there's a form of diabetes that only occurs during pregnancy. It's called gestational diabetes and it affects at least every one in ten pregnant women.
Prevalence of gestational diabetes around the world
1% to 2%

of pregnant women have existing type 1 or 2 diabetes
over 10%

of pregnant women develop gestational diabetes
30% - 70%

may experience recurring gestational diabetes in a subsequent pregnancy
Gestational diabetes is the most common complication during pregnancy. However, due to a lack of quality scientific research there are many unanswered questions about how to effectively diagnose and manage the condition.

Poor management of gestational diabetes can lead to serious health complications for both the mother and baby, including fetal macrosomia (high birth weight), maternal or fetal trauma during labor, increased risk of hypertensive disorders in the mother during pregnancy, and health problems in the baby after birth.

By following the recommended lifestyle modifications for managing gestational diabetes these risks are significantly reduced. Nevertheless, learning how to suddenly adjust your diet, exercise habits and medication needs can be pretty stressful on top of all the other challenges a woman already typically experiences during pregnancy!

Velmio is the first pregnancy app to offer a dedicated set of tools to help women navigate a pregnancy complicated by diabetes. As the first smart and inclusive pregnancy app that adapts to the user's individual health needs, it's been very important for us to place a spotlight on this significant subgroup of the pregnancy population.
Velmio's toolkit for managing diabetes during pregnancy
The Velmio app contains features specifically designed for the needs of pregnant women with gestational diabetes or pre-existing type 1 or type 2 diabetes.
Blood glucose tracking
Track your fasting, post meal and bedtime glucose readings
Insulin tracking
Track your medication to help you and your doctors understand what dosages work for you
Nutrition tracking
Nutrition therapy is typically the first point of call for diabetes management. Velmio is the first pregnancy app with advanced nutrition tracking tools for monitoring your nutritional intake
Wearable support
Lifestyle modifications are key to managing gestational diabetes. Connect your wearable device if you have one to track your exercise and set goals in accordance with your health professional's recommendations
Detailed health reports
The Velmio app generates a unique report visualizing all the data relevant to your health and diabetes management. Your doctors also find these very useful for making better clinical decisions about your health!
Personalized insights
Velmio's artificial intelligence (AI) powered insights engine responds to data you log in the app. This means that Velmio can recognize high/low blood glucose readings, and help you make sense of your nutrition and exercise data in the context of your pregnancy
What is gestational diabetes and how is it managed?

When type 1 or type 2 diabetes occurs prior to pregnancy it is labeled as "pre-existing diabetes". On the other hand, "gestational diabetes" refers to the onset of diabetes for the first time during pregnancy.

Hormonal changes during pregnancy changes a woman's insulin sensitivity. Insulin is a hormone that assists your body in using sugar (glucose) for energy. Due to the many physiological changes occurring in the body of a pregnant woman, the body requires a greater level of insulin to control the level of the glucose in the blood. You can develop gestational diabetes when your body cannot manage this increased need for insulin.

The oral glucose tolerance test (OGTT) is used at around weeks 24-28 of pregnancy to diagnose gestational diabetes, however women with certain risk factors may undergo this testing earlier to rule out the possibility of undiagnosed pre-existing diabetes.

Once a diagnosis has been established, the focus turns to managing the glucose levels to prevent adverse health outcomes for the mother and baby. Gestational diabetes increases the likelihood of a baby large for gestational age and macrosomia (high birth weight), hypertensive disorders such as preeclampsia, polyhydramnios (excess amniotic fluid), stillbirth and neonatal morbidity. In the long term, women with gestational diabetes have increased risk for later development of type 2 diabetes and the newborn may have an increased risk of developing obesity and diabetes later in life.

While this list of potential risks and complications sounds extreme, it is important to keep in mind that by following the guideline lifestyle interventions for gestational diabetes management, the likelihood of these complications occurring is significantly reduced.

Lifestyle modification is the first line of treatment for gestational diabetes. Lifestyle modification includes nutritional invention, physical activity and weight management. This treatment needs to be carefully tailored for the individual, with digital health solutions like Velmio offering an efficient method for patients and doctors to monitor the effects of lifestyle modification on the blood glucose levels.

Clinical studies support lifestyle modifications such as nutrition therapy as an effective means for reducing the rate of adverse health outcomes in newborns born to patients with gestational diabetes. Studies also support better glucose control, improved quality of life and reduced rates of postnatal depression in women following the suggested lifestyle interventions for gestational diabetes management.
Velmio generates detailed health reports helping patients and doctors understand how lifestyle modifications and/or pharmacological interventions affect the blood glucose levels
How Velmio is using artificial intelligence (AI) to improve diabetes management

Women's health has traditionally been underrepresented in medical research and a lack of quality scientific research means there are still many open questions about the optimal method for diagnosing and treating gestational diabetes. For many women lifestyle modification can successfully control the blood glucose levels without the need for a pharmacological treatment such as insulin therapy. However, the best approach for nutrition and exercise interventions remains unknown, and there isn't even a consensus on the glucose levels at which pharmacological interventions should be enacted. Existing research is limited by a one-size-fits-all approach, but gestational diabetes management needs to be carefully tailored for the individual. Artificial intelligence (AI) is driving a shift towards personalized healthcare and Velmio's technology is at the forefront of this movement.

The Velmio app offers a complete solution for capturing all the relevant aspects of the patient's health and lifestyle: blood glucose and insulin tracking, nutrition tracking, weight tracking, integration for popular wearable devices for exercise tracking, symptom tracking, risk factor assessment, environmental factors, and much more. The power of this system is that our algorithms can consider all these different aspects of a patient's health and lifestyle as a whole to understand the impact of the treatment to a level of detail never previously possible before. This makes the work of doctors easier and leads to better health outcomes for the patient.
References and resources

[1] Diabetes During Pregnancy, CDC, Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion

[2] Zhu Y, Zhang C. Prevalence of Gestational Diabetes and Risk of Progression to Type 2 Diabetes: a Global Perspective. Curr Diab Rep. 2016;16(1):7. doi:10.1007/s11892-015-0699-x

[3] Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS; Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005 Jun 16;352(24):2477-86. doi: 10.1056/NEJMoa042973. Epub 2005 Jun 12. PMID: 15951574.

[4] Reader D, Splett P, Gunderson EP; Diabetes Care and Education Dietetic Practice Group. Impact of gestational diabetes mellitus nutrition practice guidelines implemented by registered dietitians on pregnancy outcomes. J Am Diet Assoc. 2006 Sep;106(9):1426-33. doi: 10.1016/j.jada.2006.06.009. PMID: 16963348.

[5] Medical Nutrition Therapy and Lifestyle Interventions, Diane M. Reader, Diabetes Care Jul 2007, 30 (Supplement 2) S188-S193; DOI: 10.2337/dc07-s214

[6] Hernandez TL, Brand-Miller JC. Nutrition Therapy in Gestational Diabetes Mellitus: Time to Move Forward. Diabetes Care. 2018;41(7):1343-1345. doi:10.2337/dci18-0014

[7] Raman P, Shepherd E, Dowswell T, Middleton P, Crowther CA. Different methods and settings for glucose monitoring for gestational diabetes during pregnancy. Cochrane Database Syst Rev. 2017;10(10):CD011069. Published 2017 Oct 29. doi:10.1002/14651858.CD011069.pub2

[8] Nicholson WK, Wilson LM, Witkop CT, Baptiste-Roberts K, Bennett WL, Bolen S, Barone BB, Golden SH, Gary TL, Neale DM, Bass EB. Therapeutic management, delivery, and postpartum risk assessment and screening in gestational diabetes. Evid Rep Technol Assess (Full Rep). 2008 Mar;(162):1-96. PMID: 18457474; PMCID: PMC4781072.