App cuts diabetes check-ups by up to 64% in Dutch hospitals

Pregnant patients with gestational diabetes are having fewer consultations with healthcare specialists following the introduction of a home monitoring programme at Dutch hospitals, according to a new evaluation. The system allows patients to submit their blood sugar readings through an app, replacing some routine appointments with remote monitoring.

Dutch hospitals report fewer consultations for gestational diabetes

An evaluation involving six hospitals in the Santeon network found that patients using home monitoring had 28 to 64 percent fewer consultations with diabetes nurses compared to patients treated before the programme was introduced. Consultations with internists or specialist nurses also decreased by 18 percent, according to Zorg bij jou.

The programme was first introduced in March 2023 and has since been used by more than 4.000 patients across nine hospitals. In the evaluated programme, 88 percent of patients used home monitoring to track their blood sugar levels.

The evaluation found no difference in pregnancy duration or the likelihood of a caesarean section between the groups. However, the researchers noted that other changes over time may have influenced the results and that the reduction in nursing consultations could have been overestimated.

How does home monitoring work?

Patients diagnosed with gestational diabetes, a condition that causes high blood sugar during pregnancy, measure their glucose levels at home and submit the results through the Thuismeten app. The app also provides information and advice on nutrition and lifestyle.

Nurses at a central medical service centre monitor the readings remotely. If a patient's blood sugar levels fall outside the agreed range, the nurses receive an alert and can contact the patient or consult their hospital specialist. When readings are within the expected range, patients generally do not receive a response.

Some aspects of treatment still involve direct contact with hospital staff. Patients starting insulin treatment first consult a diabetes nurse, although subsequent dosage adjustments can be handled remotely under an established protocol. The patient's hospital specialist remains responsible for their treatment.

What does remote monitoring mean for patients in the Netherlands?

Fewer consultations may mean fewer trips to hospital, but they also mean less routine contact with healthcare professionals. Among patients who completed a questionnaire as part of the evaluation, 60 percent said they felt safer with remote care. However, the findings do not establish whether patients prefer remote monitoring to face-to-face appointments.

Questions about reduced personal contact are not limited to this programme. According to a report by the Dutch National Institute for Public Health and the Environment (RIVM), many patients worry about insufficient personal contact with healthcare professionals and the privacy of their medical information. The Dutch Health and Youth Care Inspectorate has also warned that digital healthcare information can be difficult to access for people with limited digital skills, while language barriers can further complicate communication with healthcare providers.

Patients can still contact healthcare professionals with questions or concerns. Participating hospitals state that patients remain under the care of their hospital specialists, although the arrangements for monitoring and contacting medical staff may differ between hospitals.

Home monitoring for gestational diabetes is not available at every hospital in the Netherlands. Patients can ask their healthcare provider about the options available to them, how often they can expect direct contact and whom to approach if they need medical assistance.