Gestational diabetes mellitus (GDM) is defined as a glucose tolerance disorder that arises during pregnancy. Once a mom been diagnosed with this condition, she will need to monitor her blood glucose level closely, follow a particular eating plan and stay active to prevent adverse outcome for herself and her baby. Nurture is a blood glucose management system that helps parents with GDM aware and in control of their health status. The system is composed of a Nurture device for the mom and a supporting mobile app for the dad.

Nurture device for mom has two parts: an ear-clip sensor that measures blood glucose level non-invasively and an interactive case that house the sensor. Besides charging and storing the ear-clip sensor, the interactive case is capable of reminding mom to test her blood glucose level 4 times a day, keeping a log of the testing results, tracking moms' food intake, providing food's nutritional data and recommending personalized meal. At the same time, it provides a convenient way to share this information with dad.

The Nurture mobile app for dad allows him to stay on track of mom's condition ( of course, upon mom's approval). Dad can get access to the testing results and food logs that mom shares. He will be informed of the limitation of food choices that mom has. Therefore, when he cooks a meal, shops groceries or buys a treat for mom, he can make a wise decision. At the same time, he will be able to understand the difficulties that mom has been through and provide proper emotional support when needed.

The Nurture glucose testing hardware and supporting software work together as a system which will guide parents with GDM to quickly adapt to the new lifestyle during pregnancy. Resulting in better-controlled blood glucose level, healthier babies and less stressful pregnant journey.

Problem discovered

Gestational Diabetes mellitus (GDM) is the condition when the body cannot produce enough insulin to balance the hormones that the placenta releases during pregnancy. It will cause high blood glucose levels (BGL) which severely impacts both the mom and baby's health.
On average about 9.2 % of moms are diagnosed with GDM. That is more than 300,000 moms and babies in the US per year. Expectant moms need to be extremely careful in monitoring and controlling their conditions. If placentas receive the abnormally higher level of blood glucose, moms and babies will have the significantly higher risk of experience birth complications including preterm birth, c-section, pre-eclampsia, macrosomia, respiratory distress, birth trauma, and cardiac malformation. Both moms and babies will have a much higher risk of developing type II diabetes later in life.

Unlike type I or type II diabetes, diagnosis of gestational diabetes happens at around 26 weeks of pregnancy. Once being diagnosed, mom (and the whole family) will need to adopt a new lifestyle instantly. She needs to prick her fingers 4 -5 times a day (after wake up and each meal), then write down the testing result each time. She also supposes to keep a food log and write down all the food intake and quantity. Before she eats every meal, she needs to study and calculate the nutritional content, especially carbohydrates and fiber. Moms will be always worried about harming her baby by eating something spikes her BGL. At the same time, dad might be frustrated because he tries to do grocery shopping and doesn't know what type of fruit is safe to her.

Unique approach

Closely monitoring and carefully dieting is crucial to be successful at controlling BGL. However, currently, all the glucose monitoring devices on the market are solely focusing on checking BGL. We see the opportunity to seamlessly merge these two closely correlated aspects.

How we achieve the goals on mom's side?

On mom's side: The Nurture device uses the newest non-invasive glucose testing technology (currently approved in Europe) to test mom's BGL. Instead of painful finger pricking, mom only needs to clip the sensor on her earlobe. All the supporting device and app helps her keep a log of her test results linked to the food that she eats. She can also easily find recipes, restaurant and raw food that are nutritionally balanced and safe for the baby. The outcome is a highly integrated process for blood glucose testing and food tracking.

How we helped dad stay in the loop?

In one of our interviews, one mom with GDM told us that her husband once brought home strawberry banana smoothie which used to be her favorite snack. He didn't know that she could not eat it during her pregnancy after being diagnosed with GDM. She told us that she was so frustrated at that point and started to cry uncontrollably. Because she was trying so hard to eliminate all foods that would spike her BGL from her diet and she had been craving for them for a long time. She didn't want to blame her husband for bringing her favorite snack because he didn't know, and at the same time she was too overwhelmed to control her emotion.

Later, we identified that the situation is common among these families. To resolve this issue, we focus on helping dad gaining more awareness of mom's new lifestyle. Furthermore, for dad's who is desperate to help, allowing them to access accurate information easily. Therefore, he can put his effort in more efficiently.

After exploring, we found solutions to achieve our goal. From dad's mobile app, dad will be able to learn (upon mom's approval) what food mom cannot tolerate based on the population database and personal input. At the same time, the system will recommend nutritionally balanced and mom-preferred food for dad to help him with meal prepping or grocery shopping.

Beyond that, dad can also remind mom when she misses testing. Our system encourages him to leave a sweet voice message to her, and she will receive it during her subsequent glucose testing. With these aspects considered, parents will have a smoother journey fighting this condition together.

User experience

Nurture is designed with parents' overall experience living with GDM in mind. The ear clip sensor supports mom by alleviating her pain of pricking her finger four times a day, promptly reminding mom to check her BGL, keeps a log of her BGL along with the food associated with it and guides her in preparing meals suitable for her.
Nurture eliminates the need for mom to experience a trial and error process repeatedly. The system will be able to interpret mom BGL results and provide database information. Thus reassuring her by informing her that, for example, it is normal to have a higher fasting BGL at week 45, but seek medical attention if it goes over 105mg/dl. Nurture learns alongside the mom about which foods work well to keep her BGL at a good range. It remembers the ingredients that spiked her level and would not include recipes or meals with those ingredients in the future. Checking mom's BGL is extremely easy and pain-free with the Nurture earpiece.

Nurture recognizes dad as a pivotal role in this stage of their lives, therefore guiding him to be a supportive partner is crucial in this loop. We provide moral support, tips, and information about what to expect in this journey. He can view his partner's BGL results, plan meals that will not spike her BGL and send an encouraging message to brighten up her day. Nurture supports, guides, and encourages both parents during this stressful but incredibly important and exciting time in their lives.