Effectiveness of Telemedicine Care Replacing Standard Care in Gestational Diabetes

Effectiveness of Telemedicine Care Replacing Standard Care in Gestational Diabetes: a Randomized Controlled Trial

This is a a single-centre, parallel, randomized controlled trial in women with gestational diabetes mellitus (GDM). Women are randomized to routine monthly prenatal clinic care (standard care group) or a group sending daily glucose readings via an application installed on a smartphone and monthly individual videoconferences replacing in-person visits (telemedicine group). The overall aim is to compare the effectiveness of the combine synchronous and asynchronous telemedicine care with the standard care in women with GDM.

In our single-centre, parallel, randomized controlled trial in women with gestational diabetes (GDM) the investigators aim to compare the effectiveness of combined synchonous and asynchronous telemedicine care with the standard care. In the telemedicine group appointments are performed online via monthly scheduled videoconferences. Women also receive a smartphone with the installed application that enable transfer of the measured capillary glucose concetration at the same time it is performed. The glucose data sent by women are reviewed once per week and after that healthcare professionals contact women if necessary. On the other hand, in the standard care group, visits are scheduled normally on a monthly basis at the diabetes clinic. Intention-to-treat analysis is going to be performed. The investigators aim to compare glycemic control, gestational weight gain and perinatal data between groups. Student's t-test or Mann-Whitney U test will be used for normally or non-normally distributed variables. Differences between groups in categorical data will be calcuated by Chi square.

In the telemedicine group, the appointments are performed online via scheduled videoconferences, on a monthly basis. All women in the telemedicine group receive a smartphone with the installed application that enable transfer of the measured capillary glucose concentration.

is defined as defined as the number of actual glucose measurements performed divided by the number of recommended glucose measurements*100

Inclusion Criteria: less then 30 weeks of gestation at enrolement GDM diagnosis at least moderate Slovenian language skills willingness to participate Exclusion Criteria: more than 30 weeks of pregnancy overt diabetes or fasting glucose >6.9 mmol/l at diagnosis multiple pregnancy poor Slovene language skills history or bariatric surgery or other surgeries that induce malabsorbtion use of systemic steroids prior to enrolment presence of concomitant disease that could affect glucose control or self-management (e.g. uncontrolled psychiatric disorder)