86 - Remote patient monitoring for diabetes management in pregnancy associated with improved maternal and neonatal outcomes

Remote Patient Monitoring (RPM) allows providers to monitor patients’ acute or chronic conditions, with near real-time data, in between clinic visits to make timely adjustments to care. Our objective was to determine if using RPM for outpatient management of diabetes in pregnancy leads to improvement in maternal and neonatal outcomes.

Study Design:

This was a retrospective cohort study of pregnant patients with diabetes managed by the Maternal Fetal Medicine practice at one academic institution between October 2019 – April 2021. The practice transitioned from paper blood glucose logs to use of EHR-based RPM tools in January 2020. RPM options included: 1) Device integration with Bluetooth glucometers that automatically upload measured glucose values to the patient’s Epic MyChart app or 2) Manual entry where patients manually log glucose readings into their MyChart app. Values in the MyChart app directly transfer to the patient’s Electronic Health Record (Epic, Verona, WI) for review by providers. In total, 533 patients were studied. We compared 173 patients with paper logs to 360 patients managed with RPM (176 device integration and 184 manual entry). Data on maternal characteristics, measures of glycemic control, and maternal and neonatal outcomes were collected.

Results:

Maternal baseline characteristics were not significantly different between the RPM and paper groups, including similar rates of gestational diabetes (94.7 vs 95.9%) and pre-gestational diabetes (5.3% vs 4.1%). RPM patients submitted more values, were more likely to achieve glycemic control in target range, and achieved target range sooner than patients managed with paper logs (Table 1). This was achieved without increasing in-person visits. RPM patients had lower rates of preeclampsia and their infants had lower rates of neonatal hypoglycemia in the first 24 hours of life (Figure 1).

Conclusion:

Remote patient monitoring for management of diabetes in pregnancy is superior to a traditional paper-based approach in achieving glycemic control and leads to improved maternal and neonatal outcomes.