Remote glucose monitoring may be viable option for women with gestational diabetes
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Key takeaways:
- Pregnant women with gestational diabetes had similar glycemic control with telemedicine vs. conventional in-person care.
- Nearly all women using telemedicine said they would recommend it to others.
Pregnant women with gestational diabetes had similar glycemic, maternal and neonatal outcomes with weekly remote glycemic monitoring as women who attended in-person appointments, according to data from a small study.
In findings published in Diabetic Medicine, pregnant women diagnosed with gestational diabetes at a clinic in Italy were enrolled into a telemedicine group in which glucose levels were transmitted remotely to a provider or a conventional group in which participants attended outpatient follow-up appointments every 2 to 3 weeks. Researchers found no differences in most outcomes between the groups, making telemedicine a potential option for gestational diabetes follow-up, according to the researchers.
“Further studies are needed to validate the positive results found on telemedicine in the treatment of gestational diabetes with a focus on maternal satisfaction,” Sara Montori, MD, of the department of medical sciences, section of obstetrics and gynecology at S. Anna University Hospital, University of Ferrara in Italy, told Healio. “The possibility of providing gestational diabetes care through telemedicine must be encouraged as it is welcomed by women.”
Montori and colleagues enrolled 60 women diagnosed with gestational diabetes between the 24th and 28th week of pregnancy from February 2018 to August 2019 at a diabetes unit in Ferrara, Italy. Women in the telemedicine group attended one in-person examination at enrollment and were provided with a glucose meter. Telemedicine participants self-performed four-point glucose level checks daily that were transferred to a virtual cloud through a smartphone app. A provider checked the glucose values once per week and started insulin therapy if women were not achieving glycemic targets. Women assigned to the conventional group attended in-person visits every 2 to 3 weeks, where glucose values were recorded. Maternal and neonatal data were obtained from medical records. Phone interviews were conducted after the study to assess diabetes care satisfaction.
There were 27 women in the telemedicine group and 33 women who participated in conventional in-person care. No difference in any maternal or neonatal outcomes were observed between the two groups. Women in the telemedicine group spent a mean of 65 total minutes in follow-up consultations compared with 97 minutes for women in the conventional group (P < .001).
Women in both groups gave positive responses to most of the post-study satisfaction questions. Women in the telemedicine group were more likely to say they felt their glycemic levels were “well controlled by the diabetes team” (P = .045) and ”this blood glucose monitor has adapted to my lifestyle” (P = .005) than women in the conventional group. Of the respondents, 24% in the telemedicine group and 39% in the conventional group said they did not perform oral glucose tolerance tests postpartum. Of the telemedicine group, 96% said they would recommend it to relatives and friends.
“Practices should implement more telemedicine for gestational diabetes,” Montori said. “The clinical implication of the study is that women who are eligible for checks and treatments with telemedicine must be selected and this practice must be encouraged, as it is appreciated by patients because it adapts better to their lifestyle and they feel better controlled.”
Montori said stronger evidence on the impact of telemedicine for gestational diabetes care is needed and randomized controlled trials should be conducted with a focus on maternal satisfaction.
For more information:
Sara Montori, MD, can be reached at mntsra1@unife.it.
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