Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain.
Int J Endocrinol. 2010;2010:386941. doi: 10.1155/2010/386941. Epub 2010 Jun 10.
Objective. To evaluate the feasibility of a telemedicine system based on Internet and a short message service in pregnancy and its influence on delivery and neonatal outcomes of women with gestational diabetes mellitus (GDM). Methods. 100 women diagnosed of GDM were randomized into two parallel groups, a control group based on traditional face-to-face outpatient clinic visits and an intervention group, which was provided with a Telemedicine system for the transmission of capillary glucose data and short text messages with weekly professional feedback. 97 women completed the study (48/49, resp.). Main Outcomes Measured. The percentage of women achieving HbA1c values <5.8%, normal vaginal delivery and having a large for-gestational-age newborn were evaluated. Results. Despite a significant reduction in outpatient clinic visits in the experimental group, particularly in insulin-treated women (2.4 versus 4.6 hours per insulin-treated woman resp.; P < .001), no significant differences were found between the experimental and traditional groups regarding HbA1c levels (all women had HbA1c <5.8% during pregnancy), normal vaginal delivery (40.8% versus 54.2%, resp.; P > .05) and large-for-gestational-age newborns (6.1% versus 8.3%, resp.; P > .05). Conclusions. The system significantly reduces the need for outpatient clinic visits and achieves similar pregnancy, delivery, and newborn outcomes.
目的。评估基于互联网和短信服务的远程医疗系统在妊娠中的可行性及其对妊娠期糖尿病(GDM)妇女分娩和新生儿结局的影响。方法。将 100 例 GDM 患者随机分为两组,对照组采用传统的面对面门诊就诊,干预组采用远程医疗系统传输毛细血管血糖数据和带有每周专业反馈的短信。97 例妇女完成了研究(48/49)。主要观察指标。评估达到 HbA1c 值<5.8%、正常阴道分娩和新生儿巨大儿的妇女比例。结果。尽管实验组的门诊就诊次数显著减少,尤其是在胰岛素治疗的妇女中(2.4 小时与 4.6 小时/胰岛素治疗妇女;P<.001),但实验组和传统组在 HbA1c 水平(所有妇女在妊娠期间 HbA1c<5.8%)、正常阴道分娩(40.8%与 54.2%;P>.05)和巨大儿(6.1%与 8.3%;P>.05)方面无显著差异。结论。该系统显著减少了门诊就诊次数,并获得了相似的妊娠、分娩和新生儿结局。