Cellular-Enabled Glucometers and Maternal Glucose Control: A Quality Improvement Initiative

Sarah A. Wernimont, Jessica S. Sheng, Diedre Fleener, Karen M. Summers, Craig Syrop, Janet I. Andrews

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Management of diabetes in pregnancy is burdensome due to self-glucose monitoring, recording, and reporting demands. Cellular-enabled glucometers provide real-time transmission of glucose values independent of internet access and cell phone data plans. We describe a quality improvement (QI) intervention that introduced cellular-enabled glucometers for use during pregnancies complicated by diabetes. Methods: Our aim was to improve maternal glucose control in a cohort of insulin-requiring pregnant women enrolled in a telemedicine diabetes program. During initial establishment of a QI program, women were offered cellular-enabled glucometers but could elect to keep their standard meter. The primary outcome evaluated was glycosylated hemoglobin A1c (HbA1c) at delivery. Results: Baseline characteristics including initial HbA1c were similar between women using a standard glucometer (n = 45) and those using a cellular-enabled glucometer (n = 72). Women who used a cellular-enabled glucometer had a lower HbA1c at delivery compared to those using a standard glucometer (5.8% vs 6.3%, P =.03). This improvement was particularly notable for women with poor glucose control (defined as HbA1c >6.5%) at initial obstetric visit. Women with poor glucose control who used a cellular-enabled glucose monitor had significantly lower HbA1c at delivery (6.0% vs 6.8%, P =.03) and greater change from initial visit compared to those using a standard glucometer (−2.6% vs −1.4%, P =.02). No statistically significant differences were detected in tracked neonatal outcomes. Conclusion: For pregnancies complicated by insulin-requiring diabetes, use of cellular-enabled glucometers as part of a perinatal diabetes program improves glucose control at delivery with timely transmission of accurate values throughout gestation.

Original languageEnglish (US)
Pages (from-to)77-82
Number of pages6
JournalJournal of Diabetes Science and Technology
Volume14
Issue number1
DOIs
StatePublished - 2019

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: SAW is funded by grant T32DK112751-01.

Keywords

  • cellular-enabled glucometer
  • diabetes
  • glucometer
  • pregnancy
  • quality
  • telemedicine

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