Thayer Sydney M, Williams Kelley J, Lawlor Megan L
Department of Obstetrics and Gynecology, Washington University in St Louis, St Louis, MO (Drs Thayer and Lawlor).
Division of Endocrinology, Washington University in St Louis, St Louis, MO (Dr Williams).
AJOG Glob Rep. 2023 Jun 12;3(3):100245. doi: 10.1016/j.xagr.2023.100245. eCollection 2023 Aug.
Diabetes mellitus is one of the most commonly encountered pregnancy complications and is associated with multiple adverse perinatal outcomes. Technology has progressed to address the unique challenges patients face in managing diabetes mellitus in pregnancy. Technology has bolstered diabetes mellitus education with smartphone applications focused on nutrition counseling and carbohydrate intake advice. Continuous glucose monitors and insulin infusion systems have shown benefit by simplifying glycemic monitoring and insulin administration. Improvements in glycemic control and perinatal outcomes have been seen with continuous glucose monitor use when compared with intermittent blood glucose monitoring, and more pregnant people are using insulin pumps instead of multiple daily insulin injections. Hybrid closed-loop systems are emerging and are able to integrate continuous glucose monitoring and insulin pump technologies while maximizing automated features in the nonpregnant population, but these have not been endorsed for use in pregnancy yet. Applying telehealth practices has been associated with high patient satisfaction among those with diabetes mellitus in pregnancy, and leveraging remote patient monitoring through telehealth platforms and short-range wireless technologies can reduce the burden of patient visits. As technology becomes more integrated into routine management of diabetes mellitus in pregnancy, practitioners should emphasize individualized counseling and device selection to ensure patient autonomy and safety.
糖尿病是最常见的妊娠并发症之一，与多种不良围产期结局相关。技术已经取得进步，以应对患者在孕期管理糖尿病时面临的独特挑战。技术通过专注于营养咨询和碳水化合物摄入建议的智能手机应用程序加强了糖尿病教育。持续葡萄糖监测仪和胰岛素输注系统通过简化血糖监测和胰岛素给药显示出益处。与间歇性血糖监测相比，使用持续葡萄糖监测仪可改善血糖控制和围产期结局，并且越来越多的孕妇正在使用胰岛素泵而非每日多次注射胰岛素。混合闭环系统正在出现，能够整合持续葡萄糖监测和胰岛素泵技术，同时在非妊娠人群中最大限度地发挥自动化功能，但这些系统尚未被批准用于妊娠。应用远程医疗实践在孕期糖尿病患者中具有较高的患者满意度，并且通过远程医疗平台和短程无线技术利用远程患者监测可以减轻患者就诊负担。随着技术越来越多地融入孕期糖尿病的常规管理，从业者应强调个性化咨询和设备选择，以确保患者的自主性和安全性。
