Telemedicine in the treatment of diabetic pregnancy

Abstract

Good diabetic control requires that treatment be continuously adapted to the patient behavior. We investigated whether the use of telemedicine could present an advantage to the management of the diabetic woman during pregnancy. A system completely automatic (DIANET system) was used. Twenty IDDM women participated in the study: 10 treated by telemedicine and 10 by conventional system, at times 'entry' (9.5 weeks), 'basal' (9.5-16.8 weeks), '1st month' of investigation, and 'end' (near delivery). All women used intensified protocols of insulin administration. The treatment with DIANET vs conventional showed a better metabolic control as estimated by profile of blood glucose absolute values (at time 'end': values significantly lower before breakfast: 87 ± 6 vs 104 ± 4 mg, lunch: 85 ± 5 vs 104 ± 4 mg, and after dinner: 102 ± 5 vs 124 ± 6 mg). These results were associated with higher insulin doses in the DIANET vs conventional treatment, and a significant reduction of hypoglycemic reaction in both group. Our results suggest that telemedicine-DIANET is a practical way of providing specialist care in the pregnancy area.