In a landmark study, researchers from Temple University School of Medicine will analyze whether the frequent monitoring and adjustment critical to the management of diabetes during pregnancy can be better accomplished by telemedicine. The ultimate goal is to reduce large birth weights, which can pave the way to later problems such as obesity and diabetes.
Gestational diabetes, which typically occurs toward the end of pregnancy, affects 3 to 5 percent of all women in the United States, and is more common in African-American, Latino, American Indian and Asian Indian populations. To keep blood sugars under control, critical for a healthy pregnancy, frequent monitoring is required so that adjustments to diet and medication can be made promptly.
Can telemedicine, primarily via the Internet, make this process easier and more effective? And, more importantly, can the use of telemedicine in managing gestational diabetes help prevent excessive growth of the fetus? These questions form the crux of a new project led by Carol Homko, R.N., Ph.D., C.D.E., assistant research professor at Temple University School of Medicine, and supported by a project grant from the National Institutes of Health.
Through a randomized trial, one group of women will be monitored the conventional way, a significant part of which involves keeping a log book of blood sugar levels and diet, and one group will be monitored through the phone and the Internet.
"When gestational diabetes gets out of control, the health of both mom and baby are threatened. My focus in this project is the major consequence of gestational diabetes-excessive growth of the fetus. Many problems can stem from being a big baby, especially a higher risk of diabetes," said Homko, who hopes to reduce the incidence of big birth weights by 10 percent through telemedicine.
"In previous studies with heart patients, another group requiring constant monitoring, we found that frequent contact via the phone and Internet was not only effective in controlling the disease but also embraced by the patient," explained Homko. "Patients loved being in touch with their physician online. And the physicians were able to react more quickly to signs of trouble-for example, a rise in blood pressure or weight."