Patients with gestational diabetes will have better pregnancy outcomes if they regulate their blood sugar levels early and keep them that way.
- Gestational diabetes patients who do not improve their blood sugar levels quickly are at an increased risk for caesarean delivery
- Being in a care programme, maintaining a healthy weight, giving up alcohol and tobacco and closely monitoring blood glucose levels help improve glycemic control
The study also shed light on the elements that helped patients manage their blood sugar levels early, including being in a gestational diabetes care programme, maintaining a healthy weight prior to pregnancy, abstaining from alcohol and tobacco during pregnancy and closely self-monitoring blood glucose levels, which patients were instructed to do four times per day.
All the participants in the study were part of the telemedicine programme for women with gestational diabetes run by the Kaiser Permanente Northern California Regional Perinatal Service Centre, or RPSC. The program provides standardized telephone advice on nutrition, exercise, glucose monitoring and blood-sugar-lowering drugs.
Does Personalized Care improve Glucose Control in Gestational Diabetes
“One thing that stood out to us about patients with early glucose control was that they were more likely to be engaged with the RPSC,” said lead author Rana Chehab, PhD, a research fellow with the Division of Research. “They were more likely to have phone calls with nurses and to do the glucose measurements at least 3 times a day.”Prior to giving birth, the blood glucose levels of over 90% of the patients who took part in the telehealth support programme dramatically improved, according to the authors, which is significant.
Glucose Control in Gestational Diabetes
In accordance with national guidelines, patients at high risk of developing gestational diabetes were screened earlier in pregnancy during the study period. Gestational diabetes is routinely screened for in pregnant Kaiser Permanente patients in Northern California near the end of the second trimester. Preeclampsia, early delivery, large-for-gestational-age babies, as well as long-term metabolic and cardiovascular issues, are just a few of the consequences that gestational diabetes can make more likely for both the mother and the unborn child.26,774 people who had signed up for Kaiser Permanente’s gestational diabetes programme in Northern California between January 2007 and December 2017 were included in the study. The patients were grouped into 4 distinct trajectories, according to the analysis of the data on glucose control levels between diagnosis and delivery. Approximately 40% of people were ‘stably optimum’, starting with strong control and keeping it. A trajectory showed that 34% of the population was ‘rapidly improving to ideal’, with rapid improvement levels. When blood glucose levels reached the American Diabetes Association’s suggested levels, glucose control was deemed to be ‘optimal’.
“Previous studies categorized women as being in control of glucose or not, but we wanted to know if the timing of glucose control attainment mattered in terms of outcomes, and it does,” she said.
Future research could compare patients in various trajectories to learn how they differ. “Some patients are able to get glycemic control relatively quickly and stay there and other patients struggle, and we don’t always know why,” said Dr Greenberg.
Source-Medindia