Abstract
Background: Management of diabetes in pregnancy is burdensome due to self-glucose monitoring, recording, and reporting demands. Cellular-enabled glucometers provide real-time transmission of glucose values independent of internet access and cell phone data plans. We describe a quality improvement (QI) intervention that introduced cellular-enabled glucometers for use during pregnancies complicated by diabetes. Methods: Our aim was to improve maternal glucose control in a cohort of insulin-requiring pregnant women enrolled in a telemedicine diabetes program. During initial establishment of a QI program, women were offered cellular-enabled glucometers but could elect to keep their standard meter. The primary outcome evaluated was glycosylated hemoglobin A1c (HbA1c) at delivery. Results: Baseline characteristics including initial HbA1c were similar between women using a standard glucometer (n = 45) and those using a cellular-enabled glucometer (n = 72). Women who used a cellular-enabled glucometer had a lower HbA1c at delivery compared to those using a standard glucometer (5.8% vs 6.3%, P =.03). This improvement was particularly notable for women with poor glucose control (defined as HbA1c >6.5%) at initial obstetric visit. Women with poor glucose control who used a cellular-enabled glucose monitor had significantly lower HbA1c at delivery (6.0% vs 6.8%, P =.03) and greater change from initial visit compared to those using a standard glucometer (−2.6% vs −1.4%, P =.02). No statistically significant differences were detected in tracked neonatal outcomes. Conclusion: For pregnancies complicated by insulin-requiring diabetes, use of cellular-enabled glucometers as part of a perinatal diabetes program improves glucose control at delivery with timely transmission of accurate values throughout gestation.
Original language | English (US) |
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Pages (from-to) | 77-82 |
Number of pages | 6 |
Journal | Journal of Diabetes Science and Technology |
Volume | 14 |
Issue number | 1 |
DOIs | |
State | Published - Jan 2019 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2019 Diabetes Technology Society.
Keywords
- cellular-enabled glucometer
- diabetes
- glucometer
- pregnancy
- quality
- telemedicine