Cellular-Enabled Glucometers and Maternal Glucose Control: A Quality Improvement Initiative.

Autor:	Wernimont SA; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.; Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA, USA., Sheng JS; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA., Fleener D; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA., Summers KM; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA., Syrop C; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA., Andrews JI; Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Jazyk:	angličtina
Zdroj:	Journal of diabetes science and technology [J Diabetes Sci Technol] 2020 Jan; Vol. 14 (1), pp. 77-82. Date of Electronic Publication: 2019 Jun 19.
DOI:	10.1177/1932296819856360
Abstrakt:	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.
Databáze:	MEDLINE
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