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1.
Stud Health Technol Inform ; 285: 205-210, 2021 Oct 27.
Article in English | MEDLINE | ID: covidwho-1502266

ABSTRACT

The aim of this paper was to evaluate the effect of telemedical care of gestational diabetes mellitus (GDM) patients with the digital treatment pathway model DiabCare Tirol. METHODS: 27 courses of patients with GDM, who were telemonitored through the integrated care program DiabCare Tirol in a diabetes outpatient clinic in Tyrol, Austria during the COVID-19 pandemic in 2020, were analyzed. In addition, randomized controlled trials (RCTs) on telemedicine interventions for GDM were researched, and their results were used for comparison with this disease management method. The patient outcome analysis was used to examine the effects of the integrated care program involving telemonitoring support and compared them to the results of RCTs in which participants were randomly assigned to one of two groups, either mobile monitored or standard treatment group. RESULTS: The feasibility of the digital treatment pathway model was confirmed in practice, as the trend analysis of the 27 GDM patients involved showed significantly improved glycaemic control. Results of RCT studies tend to support the findings of DiabCare Tirol. CONCLUSION: Benefits of telemonitoring with integrated care to support conventional therapy cannot be dismissed, especially in times of the pandemic. Continuous outcome research with larger patient numbers will be necessary to confirm the effectiveness of telemonitoring in a regular care setting.


Subject(s)
Diabetes, Gestational , Telemedicine , Austria , COVID-19 , Diabetes, Gestational/therapy , Female , Humans , Monitoring, Physiologic , Pregnancy
2.
Prim Care Diabetes ; 15(5): 887-889, 2021 10.
Article in English | MEDLINE | ID: covidwho-1336835

ABSTRACT

There is a lack of information about the maternal-fetal outcomes in patients with gestational diabetes and concomitant COVID-19; and there is even less information about the outcomes of pregnant women with gestational diabetes and COVID-19. We present a case of a primigravidae of 20-year-old woman with gestational diabetes and COVID-19 and a review of the literature.


Subject(s)
COVID-19 , Diabetes, Gestational , Pregnancy Complications, Infectious , Adult , Diabetes, Gestational/diagnosis , Diabetes, Gestational/therapy , Female , Humans , Pregnancy , Pregnancy Outcome , SARS-CoV-2 , Young Adult
3.
J Diabetes Res ; 2021: 5515902, 2021.
Article in English | MEDLINE | ID: covidwho-1301733

ABSTRACT

Objectives: The COVID-19 pandemic has forced a rapid adaptation of healthcare services to secure care for many patient groups. This includes women with gestational diabetes mellitus (GDM). We evaluated the impacts of the first COVID-19 wave on parameters such as the GDM treatment, glycemic control, and pregnancy outcomes. Methods: In this retrospective study from a reference diabetes center (Krakow, Poland), we compared patient data from two different time periods: the first wave of the COVID-19 pandemic (March 2020-June 2020) and the preceding five months (October 2019-February 2020). Data was collected from the medical records and telephone surveys. Results: We included 155 consecutive women (group N1 = 73 and group N2 = 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively). During the COVID-19 pandemic, almost half of all GDM women (N1 = 36, 49.3%) used telemedicine as a method of contacting their diabetic specialists while this tool was not utilized in the earlier period. Moreover, these patients reported difficulties in performing blood glucose self-control more often (N1 = 20, 27.4%, vs N2 = 7, 8.5%; p ≤ 0.01) and spent less time on diabetes education than the control group on average (N1 = 39, 53.4%, vs N2 = 9, 9.8% below 2 hours of training; p ≤ 0.01). Most analyzed glycemic parameters and pregnancy outcomes were similar. Differences were found with respect to the incidence of prolonged labor (N1 = 12, 16.4%, vs N2 = 3, 3.7%; p ≤ 0.01) and preeclampsia (N1 = 0 vs N2 = 7, 8.5%; p = 0.01). Conclusion: In this single-center observational study, the first wave of the COVID-19 pandemic did not seem to have a negative impact on pregnancy outcomes in GDM women, despite the difficulties in diabetes management delivery.


Subject(s)
COVID-19/epidemiology , Diabetes, Gestational/therapy , Pandemics , SARS-CoV-2 , Adult , Blood Glucose/metabolism , Diabetes, Gestational/blood , Disease Management , Female , Humans , Infant, Newborn , Male , Poland/epidemiology , Pregnancy , Pregnancy Outcome , Retrospective Studies , Telemedicine
4.
Nutr Metab Cardiovasc Dis ; 31(7): 2151-2155, 2021 06 30.
Article in English | MEDLINE | ID: covidwho-1246118

ABSTRACT

AIM: To discuss available information on the opportunity for pregnant women affected by diabetes/obesity to receive COVID-19 vaccine. DATA SYNTHESIS: Pregnant women with SARS-CoV-2 (COVID-19) infection are at high risk for severe acute respiratory syndrome and adverse outcomes. Pregnant women with severe COVID-19 present increased rates of preterm delivery (<37 gestational weeks), cesarean delivery and neonatal admissions to the intensive care unit. Comorbidity such as diabetes (pregestational or gestational) or obesity further increased maternal and fetal complications. It is known that diabetic or obese patients with COVID-19 present an unfavorable course and a worse prognosis, with a direct association between worse outcome and suboptimal glycol-metabolic control or body mass index (BMI) levels. Critical COVID-19 infection prevention is important for both mother and fetus. Vaccination during pregnancy is a common practice. Vaccines against COVID-19 are distributed across the world with some population considered to have a priority. Since pregnant women are excluded from clinical trials very little information are available on safety and efficacy of COVD-19 vaccines during pregnancy. However, it is well known the concept of passive immunization of the newborn obtained with transplacental passage of protective antibodies into the fetal/neonatal circulation after maternal infection or vaccination. Moreover, it has been reported that COVID-19 vaccine-induced IgG pass to the neonates through breastmilk. Therefore, maternal vaccination can protect mother, fetus and baby. CONCLUSIONS: After an individual risk/benefit evaluation pregnant and lactating women should be counselled to receive COVID-19 vaccines.


Subject(s)
Blood Glucose/metabolism , COVID-19 Vaccines/administration & dosage , COVID-19/prevention & control , Diabetes, Gestational/blood , Lactation , Pregnancy Complications, Infectious/prevention & control , Pregnancy in Diabetics/blood , SARS-CoV-2/pathogenicity , Vaccination , Antibodies, Viral/blood , Biomarkers/blood , Body Mass Index , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/adverse effects , Clinical Decision-Making , Diabetes, Gestational/diagnosis , Diabetes, Gestational/therapy , Female , Glycemic Control , Humans , Immunity, Maternally-Acquired , Maternal-Fetal Exchange , Milk, Human/immunology , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/immunology , Pregnancy Complications, Infectious/virology , Pregnancy in Diabetics/diagnosis , Pregnancy in Diabetics/therapy , Prenatal Care , Risk Assessment , Risk Factors , SARS-CoV-2/immunology , Vaccination/adverse effects
5.
Diabetes Technol Ther ; 23(5): 358-366, 2021 05.
Article in English | MEDLINE | ID: covidwho-1217792

ABSTRACT

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first identified during pregnancy. Delays in diagnosis and challenges in management can lead to serious adverse outcomes for the mother and child. As rates of GDM diagnosis increase worldwide, health systems and maternity services have become increasingly strained, especially with new restrictions around in-person care due to the current COVID-19 pandemic. Mobile health (mHealth) has increasingly shown promise for management of chronic disease, driven by smartphone adoption and increased internet connectivity. The aim of this work was to evaluate the adoption and multidisciplinary care coordination of an mHealth platform called M♡THer in a cohort of women with first-time diagnosis of GDM. Methods: The mHealth platform for GDM management was developed incorporating a smartphone application, clinician portal, and secure cloud data storage. Forty participants with a first-time diagnosis of GDM were recruited to use the app during their pregnancy. User attitudes from clinicians and women were captured through post-hoc surveys, and app-usage metrics. Results: Clinicians and women indicated satisfaction and ease of use of the mHealth platform, with some technological challenges around wireless connectivity. Blood glucose reviews and antenatal contact were higher with use of the M♡THer app compared with a matched historical sample. Conclusion: The M♡THer mHealth platform is a new comprehensive tool for health care of women with GDM, and may provide an effective new avenue to enhance multidisciplinary care in the face of COVID-19 disruptions and challenges to traditional care pathways.


Subject(s)
COVID-19 , Diabetes, Gestational/therapy , Mobile Applications , Pandemics , Telemedicine/methods , Women's Health , Adult , Blood Glucose/analysis , Blood Glucose Self-Monitoring , Cohort Studies , Feasibility Studies , Female , Humans , Patient Care Team , Patient Satisfaction , Pregnancy , Smartphone , Young Adult
6.
Diabetes Technol Ther ; 23(5): 358-366, 2021 05.
Article in English | MEDLINE | ID: covidwho-983529

ABSTRACT

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance first identified during pregnancy. Delays in diagnosis and challenges in management can lead to serious adverse outcomes for the mother and child. As rates of GDM diagnosis increase worldwide, health systems and maternity services have become increasingly strained, especially with new restrictions around in-person care due to the current COVID-19 pandemic. Mobile health (mHealth) has increasingly shown promise for management of chronic disease, driven by smartphone adoption and increased internet connectivity. The aim of this work was to evaluate the adoption and multidisciplinary care coordination of an mHealth platform called M♡THer in a cohort of women with first-time diagnosis of GDM. Methods: The mHealth platform for GDM management was developed incorporating a smartphone application, clinician portal, and secure cloud data storage. Forty participants with a first-time diagnosis of GDM were recruited to use the app during their pregnancy. User attitudes from clinicians and women were captured through post-hoc surveys, and app-usage metrics. Results: Clinicians and women indicated satisfaction and ease of use of the mHealth platform, with some technological challenges around wireless connectivity. Blood glucose reviews and antenatal contact were higher with use of the M♡THer app compared with a matched historical sample. Conclusion: The M♡THer mHealth platform is a new comprehensive tool for health care of women with GDM, and may provide an effective new avenue to enhance multidisciplinary care in the face of COVID-19 disruptions and challenges to traditional care pathways.


Subject(s)
COVID-19 , Diabetes, Gestational/therapy , Mobile Applications , Pandemics , Telemedicine/methods , Women's Health , Adult , Blood Glucose/analysis , Blood Glucose Self-Monitoring , Cohort Studies , Feasibility Studies , Female , Humans , Patient Care Team , Patient Satisfaction , Pregnancy , Smartphone , Young Adult
8.
Diabetes Res Clin Pract ; 169: 108396, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-739800

ABSTRACT

We describe our experience in the remote management of women with gestational diabetes mellitus during the COVID-19 pandemic. We used a mobile phone application with artificial intelligence that automatically classifies and analyses the data (ketonuria, diet transgressions, and blood glucose values), making adjustment recommendations regarding the diet or insulin treatment.


Subject(s)
COVID-19/complications , Diabetes, Gestational/therapy , SARS-CoV-2/isolation & purification , Smartphone/statistics & numerical data , Telemedicine/methods , Artificial Intelligence , Blood Glucose/analysis , Blood Glucose Self-Monitoring/methods , COVID-19/virology , Diabetes, Gestational/blood , Diabetes, Gestational/epidemiology , Diabetes, Gestational/virology , Disease Management , Female , Humans , Pregnancy , Spain/epidemiology
10.
Diabetes Metab Syndr ; 14(5): 939-942, 2020.
Article in English | MEDLINE | ID: covidwho-600927

ABSTRACT

BACKGROUND AND AIMS: New clinical approaches are needed to minimize complications of gestational diabetes during the COVID-19 outbreak with timely screening and proper management. The present study aims to highlight changes in the clinical guideline for gestational diabetes during the pandemic. METHODS: In a narrative review, multiple databases were searched. Furthermore, online searches were conducted to identify guidelines or support documents provided by NGOs, local health authorities, and societies and organizations in the field of diabetes and obstetrics. RESULTS: We included five national guidelines that were published in English from Canada, the United Kingdom, Australia, New Zealand, and Australia health agencies. FBG, A1C, RPG were recommended as alternative tests instead of a 2-h oral glucose tolerance test (OGGT) for GDM screening at 24-28 weeks of gestation. Recommendations also included a deferral of postpartum screening till the end of the pandemic, or postponement of testing to 6-12 months after delivery, use telemedicine and telecare. CONCLUSIONS: Updated temporary changes in clinical guidelines are sensible and accommodates social distancing and minimizes risk of exposure to COVID-19. Despite many unsolved controversies in screening, treatment, and follow-up of gestational diabetes, it seems involvement with novel coronavirus have made a reach to a global agreement simpler.


Subject(s)
Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Diabetes, Gestational/diagnosis , Diabetes, Gestational/therapy , Pneumonia, Viral/complications , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/standards , Pregnancy Complications, Infectious/prevention & control , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diabetes, Gestational/virology , Disease Management , Female , Humans , Iran/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pregnancy , Prognosis , SARS-CoV-2
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