Smart glucose meters improve diabetes management in pregnancy
HOUSTON — Remote monitoring of pregnant women with diabetes via a smart glucose meter increased patient engagement with diabetes care and education specialists and better informed treatment decisions, according to study data presented at the American Association of Diabetes Educators annual meeting.
“Using the cellular-connected glucometer allowed diabetes educators to receive accurate blood glucose data, which led to the increased use of continuous glucose monitors and informed treatment decisions,” Kathleen Fincher, MS, RD, LD, CDE, a registered dietitian and certified diabetes educator with Prisma Health in Greenville, South Carolina, told Endocrine Today. “The use of the cellular-connected glucometer revealed how infrequently many patients monitor their blood glucose, which was inconsistent with the number of blood glucose checks recorded on paper logs.”
Fincher and colleagues analyzed data from 50 pregnant women with type 1 or type 2 diabetes who received standard care plus a cellular-enabled blood glucose meter (n = 25; mean age, 29 years; mean gestational age, 10.8 weeks; 68% with type 2 diabetes) or standard care alone (controls; n = 25; mean age, 32 years; mean gestational age, 15.4 weeks; 76% with type 2 diabetes). Blood glucose readings taken with the smart meter were automatically uploaded to a patient portal via cellular connectivity and were reviewed daily by diabetes educators. Providers contacted patients when blood glucose readings were less than 50 mg/dL or when there were two consecutive readings of more than 200 mg/dL. Contact was made by telephone, email, text message or message sent directly to the meter. Patients were followed through pregnancy until 6 weeks postpartum.
Women who used the smart meter reported more hypoglycemic events during pregnancy compared with controls (mean, 12.7 vs. 5.6; P = .18) as well as more hyperglycemic events vs. controls (mean, 20.5 vs. 9.32; P = .141). Women in the smart meter group were also more likely to use a CGM vs. controls (15 vs. 6; P = .01). There were no between-group differences in mode of delivery or maternal complications, although women in the smart meter group delivered at an earlier gestational age vs. controls (mean, 34.8 weeks vs. 36 weeks; P = .213). There were no between-group differences in neonatal complications apart from neonatal hypoglycemia, which was less frequent in the intervention group (3 vs. 9; P = .047).
The researchers noted that most patients in the intervention group completed the study (88%), attended the postpartum visit and had a primary care provider or were referred to one for long-term diabetes management.
“Further research may be beneficial on the use of continuous glucose monitors during pregnancy,” Fincher said. – by Regina Schaffer
Brauss A, et al. P331. Presented at: American Association of Diabetes Educators; Aug. 9-12, 2019; Houston.
Disclosures: The authors report no relevant financial disclosures.