Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jul 25, 2020
Date Accepted: Mar 29, 2021
Date Submitted to PubMed: Mar 30, 2021
Comparing the blood glucose control efficacy of telemedicine with that of standard prenatal care in women with gestational diabetes mellitus: a randomized controlled trial
ABSTRACT
Background:
Gestational diabetes mellitus (GDM) can usually be well controlled by health education and lifestyle management, expecting a better pregnancy outcome. However, standard clinical prenatal care, which consists of clinic visits every two weeks, may not give full play to the effects of GDM management. Telemedicine shows potential to fill this gap.
Objective:
We performed a multicenter, randomized controlled trial to investigate whether health education and lifestyle management provided through a WeChat group chat was more effective in controlling blood glucose (BG) than standard clinical prenatal care among women with GDM.
Methods:
Women with GDM diagnosed by an oral glucose tolerance test (OGTT) between 23 and 30+6 gestational weeks were randomized to a WeChat group chat-based BG management group or a routine clinical prenatal care group. The primary outcome was the change in the glycemic qualification rate during the follow-up period in both groups. The second outcome was pregnancy outcomes.
Results:
A total of 309 women with GDM participated in the trial, with 162 women randomized to the control group and 147 to the intervention group. No significant differences in baseline characteristics were found between the control and intervention groups. Participants were divided into four stages (Group Ⅰ- Group Ⅳ) according to gestational weeks at enrollment for further analysis. The glycemic qualification rate of the intervention group was higher than that of the control group at nearly all time points in Group Ⅰ- Group Ⅲ, yet the differences were not significant in most cases. This was not observed in Group IV. The glycemic qualification rate gradually increased as gestational weeks progressed in both groups, regardless of the intervention method. None of the pregnancy outcomes measured were significantly different between the control and intervention groups.
Conclusions:
This multicenter randomized trial that assessed noninsulin-dependent GDM women demonstrated that additional instant messaging platforms, such as WeChat, used for health education and lifestyle intervention in China tend to be more effective for BG control than only standard clinical prenatal care. Clinical Trial: ClinicalTrials.gov NCT03748576
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