Study to assess telemedicine as tool to monitor gestational diabetes
In the first study of its kind, researchers at the School of Medicine will analyze whether the frequent monitoring and adjustment critical to the management of diabetes during pregnancy can be better accomplished virtually. 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 black, Latino, Native American 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, assistant research professor at the School of Medicine, and supported by a 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 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.
For any patient, old or young, sick or healthy, frequent hospital or doctor’s office visits to monitor a medical condition or disease are difficult and time-consuming.
“I spend a large part of my day on the phone because of the amount of monitoring and interaction needed with patients,” Homko said. “It wouldn’t be practical for my patients to come to the hospital all of the time. My job is to figure out how to adjust medication, insulin and diet, according to their blood sugar levels and other symptoms.”
On the Web site for this project, patients regularly enter their blood sugar levels and insulin doses. Homko monitors the information and e-mails responses. The Web site will soon have automated messages, such as reminders to patients to send in their numbers, in addition to a section for education. Physicians can go to the site and screen patients’ most recent lab results, ultrasounds, medications, pregnancy history and medical history.
Valerie Whiteman, assistant professor of obstetrics and gynecology, is the project co-investigator.
- By Eryn Jelesiewicz