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Int J Endocrinol. 2010;2010:386941. doi: 10.1155/2010/386941. Epub 2010 Jun 10.

The outcomes of gestational diabetes mellitus after a telecare approach are not inferior to traditional outpatient clinic visits.

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1
Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain.

Abstract

OBJECTIVE:

To evaluate the feasibility of a telemedicine system based on Internet and a short message service in pregnancy and its influence on delivery and neonatal outcomes of women with gestational diabetes mellitus (GDM).

METHODS:

100 women diagnosed of GDM were randomized into two parallel groups, a control group based on traditional face-to-face outpatient clinic visits and an intervention group, which was provided with a Telemedicine system for the transmission of capillary glucose data and short text messages with weekly professional feedback. 97 women completed the study (48/49, resp.).

MAIN OUTCOMES MEASURED:

The percentage of women achieving HbA1c values <5.8%, normal vaginal delivery and having a large for-gestational-age newborn were evaluated.

RESULTS:

Despite a significant reduction in outpatient clinic visits in the experimental group, particularly in insulin-treated women (2.4 versus 4.6 hours per insulin-treated woman resp.; P < .001), no significant differences were found between the experimental and traditional groups regarding HbA1c levels (all women had HbA1c <5.8% during pregnancy), normal vaginal delivery (40.8% versus 54.2%, resp.; P > .05) and large-for-gestational-age newborns (6.1% versus 8.3%, resp.; P > .05).

CONCLUSIONS:

The system significantly reduces the need for outpatient clinic visits and achieves similar pregnancy, delivery, and newborn outcomes.

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