Introduction: 

Gestational diabetes Mellitus (GDM) is an emerging public health concern where diabetes is first noticed during pregnancy and commonly suspended from six weeks after delivery. Around 75%-90% cases of diabetes during pregnancy are GDM, differs from pre-existing diabetes and diabetes in pregnancy.

GDM is a major threat to both mother and child which gives rise to higher rates of maternal hypertension, pre-eclampsia, difficult labor and increase in surgical intervention. Major adverse outcome of fetus and neonate are preterm delivery, risk of stillbirth, hypoglycemia in newborn, hyper bilirubinemia, macrosomia and other metabolic disorder of the off springs. 

GDM is increasing in an unprecedented manner accounting to one in seven births globally. South Asia seems to be the highest; one quarter of all births are affected by high glucose level. In Bangladesh, the recent published data unveiled the rate is 35% which is at least three times higher than that was one decade back.

Issues around management of GDM:

Management of GDM is a complex procedure and to keep the blood sugar level within targeted value is in the core to avoid the related adverse events. The modalities of treatment are diet manipulation, exercise and pharmacological agents. Food habit and lifestyle is one of the major hindrances in the self-management of GDM. Without involving the patient in the management, it is difficult to control GDM adequately. This is achieved primarily by transferring knowledge and skill to the patient which is designated as ‘Patient Empowerment’. Considering choice of food and food culture, differs in different geographical areas and communities.   Patient empowerment help mothers to select food on their own choice and availability   within the daily Calorie allowance.  Women if fail to remain within target range of blood sugar, Insulin Injection is added. To control diabetes through a self-management approach based on dietary adjustment and exercise is suitable for approximately 65-90% women with GDM.

BAN-GDM app:

The present app has been developed with the aim to establish a good feto-maternal outcome in GDM patients through desired glycemic control. This AI based app adopted patient empowerment as a management tool with the application of Long Short-Term memory (LSTM) neural network enabling patient health status prediction focusing the attention on diabetes. It has involved a Multi- Layer Perception (MLP) algorithm that fully embedded into an Enterprise Resource Planning (ERP) platform. However, it represents a practical application of the LSTM into the decision support system (DSSs) suitable for home care assistance and for de-hospitalization of GDM cases but not restricting the scheduled antenatal care and institutional delivery. Appropriate use of the app will reduce the challenges of repeated monitoring, coaching and re-coaching of patients and families, and to make a wide spread coverage. 

In conclusion it can be said that patient empowerment is a cost-effective novel self-management tool that can be introduced in a low resource setting and an AI based apps can be adopted as a sustainable way of GDM management.