P56 Usefulness of virtual tools and telemedicine in the management of Gestational Diabetes during the COVID-19 pandemic in CABA

Abstract

Introduction: Pregnant women with gestational diabetes require frequent consultations with the health professionals. Due to the risk of contracting severe forms of COVID-19, multiple international societies advise the use of virtual tools to reduce traffic the influx to and from health centers.1 However, there is no evidence supports that the use of telemedicine in gestational diabetes produces causes complications during in the management of insulinization or nor if it is effective in reducing the risk of complications associated with gestational diabetes.2

Goals: To describe the follow-up and the bitometric results, birth weight and perinatological complications in a group of women diagnosed with gestational diabetes during the covid19 pandemic using virtual tools. Evaluate secondarily whether the number of virtual visits is associated with better perinatological results.

Materials and methods: All pregnant women with a history of diabetes or diagnosis of gestational diabetes were contacted via e-mail with by the Endocrinology and Diabetes team. From that moment of diagnosis until the end of the pregnancy, virtual follow-up was carried out. Initially, educational materials and brochures were sent via e-mail. They were instructed on glycemic monitoring, insulin treatment, and phone calls were arranged. In this descriptive observational study, anthropometric variables and the presence of associated factors were analyzed. Biochemical parameters, biometric data, insulin use, maximum dose and presence of hypoglycemia were recorded. The total number of contacts, route of termination of pregnancy, birth weight and presence of complications were analyzed. Qualitative variables are expressed in contingency tables, quantitative variables are expressed in measures of position and dispersion. (Mean, median, SD, Range).

Results: 72 pregnant women with diabetes were included from March 18 to August 18, 2020, of which 41 had reached full term pregnancy. For the baseline characteristics see table 1. The mean follow-up was 11.6 ± 7.4 weeks, 34% used diet as treatment and 65.8% diet and insulin, average dose: 0.3 ± 0.2 IU x kg, maternal weight delta 10.4 ± 5.1Kg, fructosamine at the end of pregnancy 171 ± 34.5. The mean virtual interaction was 7.5 ± 5 visits during follow-up, 2 (0-11) face-to-face visits for the gestational group and 8.5 (0-16) for the pre-pregnancy group. No patient had covid during pregnancy. Route of completion due to delivery 31%, preterm 7.4%, complications 7.3%, birth weight: 3450 ± 497 grams, macrosomia 7.32%. 7.9 ± 5.6 virtual visits were required in the patients on insulin and 6.7 ± 3.6 in those who were on a diet (p = 0.63). Birth weight 3265 ± 151 grs vs 3539 ± 87 grs in the diet and insulin group respectively (p = 0.10). Birth weight 3359 ± 364 grams and 3516 ± 584 grams with more or less than 7 virtual visits respectively (p 0.23), no significant differences were found.

Conclusions: We found a low number of complications and adequate control parameters in this population in which virtual follow-up were performed. There were no differences in obstetric results according to the number of virtual visits.