Improving gestational diabetes care: Mobile glucose monitoring to reduce complications - 31/07/24

Doi : 10.1016/j.ando.2024.07.003

Zélie Leyris ^a, Laura Bidan ^a, Quentin Puel ^b, Sophie Galinat ^c, Yves Aubard ^a, Alix Tordjman ^a, Tiffany Galinat ^c, Marie-Pierre Teissier ^c,^d, Laurence Salle ^c,^d,⁎
^a Gynecology and Obstetrics Department, Limoges University Hospital Center, Limoges, France
^b Pharmacology Department, Limoges University Hospital Center, Limoges, France
^c Endocrinology and Diabetology Department, Limoges University Hospital Center, Limoges, France
^d Inserm U1094, IRD U270, University Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France

^⁎Corresponding author. Gynecology and Obstetrics Department, Limoges University Hospital Center, 87042 Limoges, France.Gynecology and Obstetrics Department, Limoges University Hospital CenterLimoges87042France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 31 July 2024

Abstract

Background

Gestational diabetes mellitus (GDM) incurs risks for both mother and baby and requires close medical attention throughout pregnancy. This retrospective study examined the impact of myDiabby® software on GDM care and complications.

Material and methods

The study population was divided between a pre-MyDiabby® group, with traditional monitoring before September 2017, and a myDiabby® group, using the myDiabby® app after September 2017. The aim was to compare the main complications of GDM and blood glucose control between the two groups, using Fisher's exact test or bilateral Student t-test as appropriate. Backward logistic regression was used to identify independent factors associated with glycemic control and caesarean section (C-section).

Results

There were 622 pre-myDiabby® and 649 myDiabby® patients. The myDiabby® group showed significantly lower risk of C-section (17.2% vs. 11.3%, P=0.004). After adjustment for pre-pregnancy body mass index (BMI), maternal age, prematurity, macrosomia and eclampsia, telemedicine was independently associated with a lower rate of C-section (OR=0.67, 95% CI: 0.51–0.89, P=0.005). Glycemic control improved (66.6% vs. 85.4%, P<0.001), with only a trend for need of insulin treatment. MyDiabby® remained associated with glycemic control (OR=3.15, 95% CI: 2.87–4.33, P<0.001) independently of pre-pregnancy BMI, insulin treatment or personal history of GDM.