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Published on March 08, 2022

pregnant woman on virtual visit with doc

Virtual Monitoring Pinpoints Gestational Diabetes Before it ‘Gets Out of Control’

A new program that connects rural mothers-to-be with virtual monitoring for gestational diabetes is already showing signs of success with fewer complications for both mothers and babies.

The program’s focus is to make it easier for patients; saving them trips to clinics or hospitals using the monitors, which automatically send data, as well as virtual visits. These tools would “meet patients where they live” and focus on convenience in care.

“We’re saving a lot of moms the burdens that might come with an appointment, hours of travel and other issues,” said Kimberlee McKay, MD, Avera Medical Group. “When we can provide an ‘easy’ button, we can help make sure better outcomes take place."

“We met with moms-to-be in bathrooms, breakrooms and teachers’ lounges,“ McKay continued. “We made it convenient for every patient, and we were able to coach, chart and coax them, even if they were hours away from us.”

The program began in 2016, and now can show its results, which include:

  • A decrease in vaginal delivery complications of almost 27%
  • A decrease in cesarean delivery complications of almost 18%
  • A reduction in the number of infants born at weights of 4000 grams (about 8.8 pounds) or more

Avera teams included registered dietitians and certified diabetes educators who used Avera’s virtual visit platform to conduct their interactions with moms in South Dakota. To monitor their patients, the team used a special glucose monitor that provided real-time information to the professionals who then could call and coach moms-to-be when blood sugar readings were too high.

“Our hypothesis was whether this sort of coaching would work. We’ve found it does work,” McKay said. “The challenge remaining is reimbursement. It can take so long.”

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The Threat Avera Wants to Stop

Gestational diabetes is often symptomless and if unnoticed, can lead to high blood pressure, preeclampsia and other serious complications. It also doubles the chance the newborn will contract type 2 diabetes later in life. “We developed a specialized blood sugar monitor to track numbers,” McKay said. “We also had to do a lot of talking and teaching. That can be daunting via telehealth.”

Since the program began, it’s served more than 450 patients. McKay and her team quickly realized the necessity for their outreach.

“When we see an abnormal glucose level on the monitor, we can call the mom right away,” McKay said. “With timely meds or coaching, we can address a problem before it gets out of control.”

Creative Coaching for Patients in 'Food Deserts'

The Avera teams knew their patients lived in places where sometimes food choices were limited. Advising moms-to-be to “eat more fresh food” wasn’t always easy.

“Healthy eating is complicated, especially in rural areas,” McKay said. “We could coach them on best choices even at a convenience store or a fast-food restaurant.”

Making these conversations simpler is one of the reasons the program works.

The program has grown, and now serves patients in Minnesota. It’ll soon reach patients in Iowa and Nebraska. McKay said making the program available to every patient is important. That takes funding. The grant from the Health Resources & Services Administration got the program started.

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