Abstract
1015: Cellular-enabled glucometer use in poorly controlled diabetes is associated with improved maternal glucose control in pregnancy
American journal of obstetrics and gynecology, Vol.218(1 Supplement), pp.S599-S599
01/2018
DOI: 10.1016/j.ajog.2017.11.552
Abstract
Objective
Management of diabetes in pregnancy can be burdensome due to self-glucose monitoring, recording and reporting demands. Cellular-enabled glucometers allow for real time transmission of glucose values independent of internet access and cell phone data plans and have shown improved glucose control outside of pregnancy. We hypothesized that women with insulin-requiring diabetes who use cellular-enabled glucometers during pregnancy would have improved maternal glucose control and neonatal outcomes.
Study Design
We performed a prospective cohort study of insulin requiring pregnant women enrolled in a telemedicine diabetes program. Women were offered cellular-enabled glucometers but could elect to keep their standard meter upon enrollment. The primary outcomes evaluated were glycosylated hemoglobin A1c (HbA1c) and a neonatal composite of hypoglycemia, large for gestational age, preterm birth and hyperbilirubinemia requiring phototherapy. A subanalysis for the above outcomes was performed for women with poorly controlled diabetes at initial prenatal care visit defined as HbA1c >6.5% by American Diabetes Association guidelines. All results were analyzed by Fisher’s exact test or ANOVA as indicated. p<0.05 was considered statistically significant.
Results
Baseline characteristics were similar between women using a standard glucometer (N=35) and those using a cellular-enabled glucometer (N=63). HbA1c at initial prenatal visit was similar between the two groups. Glucose control improved in both groups during pregnancy and was not significantly different at delivery. However, when considering women with poorly controlled diabetes, those using cellular-enabled glucose monitoring had a significantly lower HgbA1c at delivery (6.03% vs 6.64%, p=0.03) and greater change from initial visit compared to those using a standard meter (-1.71 % vs -1.25 %, p=0.01). There were no statistically significant differences in neonatal outcomes.
Conclusion
While HbA1C tends to improve across pregnancy for all women enrolled in a telemedicine diabetes program, glucose control is most improved for women with poorly controlled diabetes using a cellular-enabled glucometer. These glucometers improve communication of accurate values and facilitate delivery of care.
Details
- Title: Subtitle
- 1015: Cellular-enabled glucometer use in poorly controlled diabetes is associated with improved maternal glucose control in pregnancy
- Creators
- Sarah Wernimont - University of IowaJessica S. Sheng - University of IowaDiedre K. Fleener - University of IowaFanta Traore - University of IowaCraig H. Syrop - University of IowaJanet I. Andrews - University of Iowa
- Resource Type
- Abstract
- Publication Details
- American journal of obstetrics and gynecology, Vol.218(1 Supplement), pp.S599-S599
- Publisher
- MOSBY-ELSEVIER; NEW YORK
- DOI
- 10.1016/j.ajog.2017.11.552
- ISSN
- 0002-9378
- eISSN
- 1097-6868
- Language
- English
- Date published
- 01/2018
- Academic Unit
- Obstetrics and Gynecology
- Record Identifier
- 9984697131702771
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