Innovations in Diabetes Management to Improve Health Outcomes of Pregnant Women
By Kalyan Sattaru
Since the start of the pandemic, pregnant women have been exposed to a multitude of health problems. Access to timely maternal health care has been disrupted, with closures and reduced availability of health services contributing to disruptions to regular prenatal check-ups. A recent study by the Indian Council for Medical Research (ICMR) indicates that the second wave of COVID-19 infections was more difficult, as more pregnant and postpartum women were severely affected than during the first wave. This highlights the urgent need to facilitate and prioritize effective medical care for pregnant women in the country.
Fear of infection, coupled with the lack of routine antenatal care, continues to prevent pregnant women from going to hospital. Amidst the uncertainty and faced with limited options, pregnant women may have overlooked other health issues and challenges. One of these challenges is gestational diabetes – diabetes in pregnancy – which, when neglected, can have potentially harmful long-term consequences for mother and child.
Due to its increasing prevalence, gestational diabetes (GDM) is a public health priority in India. This can lead to worrying complications for the health of mother and child, including a risk of hypoglycemia and pregnancy-related complications, a high risk of GDM in future pregnancies and a risk of type 2 diabetes and cardiovascular complications later in life. As these risks increase with glycemic variability, effective management of glucose levels is essential to ensure that pregnant women stay healthy. This is even more important now, in the context of the health and access challenges associated with COVID, to avoid the unwanted consequences of poorly controlled diabetes.
The arguments in favor of effective management of GDM
With pregnant women now living much of their pregnancies confined to their homes and limited medical visits, regular diabetes monitoring can be overlooked, with blood sugar fluctuations going unnoticed. This requires a solution to more effectively monitor his condition and inform in real time the intervention and management of diabetes.
As with patients with type 1 and type 2 diabetes, continuous glucose monitoring has heralded a new monitoring and management paradigm for patients with GDM. At a time when our healthcare system is overloaded and resources allocated to noncommunicable diseases are limited, such accessible and technologically innovative solutions can become a mainstay of effective disease management at home. By enabling early detection, remote care, holistic information and comprehensive measurements, sensor-based blood glucose monitors provide better diabetes management for better health outcomes in mothers and children.
Sensor-based glucose monitors record glucose levels periodically, rather than at one point in time, as people go about their daily activities. The information gathered paints a rich picture of trends in glucose levels, which can detect fluctuations that otherwise would go unnoticed. Early detection allows the mother to seek prompt care to manage the glucose levels.
Enabling remote care and holistic information for real-time intervention
Home testing during pregnancy is difficult. Even with a traditional glucometer, the device can not only underestimate the number of hyperglycemic4 events experienced, but also cause pain and problems due to the prick of the fingers. The alternative of going to a lab or clinic is burdensome in these times of COVID.
Sensor devices are an effective option for continuous measurement of glucose levels and are easy to use in the comfort of your home. With these devices, it is possible to quickly access information on ups and downs, spikes after meals and even trends overnight. The expectant mother can share this data with her doctor, in the form of visual trend charts that can inform clinical decision making. This enables more efficient remote consultation and care, as well as meaningful doctor-patient conversations that make diabetes management easier.
Comprehensive measurement of gestational diabetes
While there are several measurements of glucose levels, including postprandial blood sugar (PPBS), fasting blood sugar, and HbA1C, these measurements are limited to showing glucose levels at a point in time or as an average level. . Sensor-based glucose monitors offer a unique vital metric – Time in Range (TIR), which measures the time the patient spends within a target or recommended blood glucose range. This provides a direct measure of the variability in glucose levels, allowing physicians to personalize treatment plans and patients to spend more time in reach. For pregnant women, TIR can quantitatively measure glycemic control and diabetes management, enabling rapid, real-time interventions to reduce variability and thereby improve health outcomes for both mother and unborn child.
Women with GDM face the unique challenge of having to understand the condition, seek treatment, and take management actions while dealing with the physical and mental changes associated with pregnancy. In a short time, they must learn to optimize their glycemic control and minimize the complications associated with gestational diabetes. By regularly monitoring glucose levels, they can effectively monitor their condition at home, receive care from a distance, act quickly to prevent variability, and help them navigate this pandemic with healthy pregnancy and childbirth outcomes.
(The author is Managing Director, Abbott’s Diabetes Care Business, India. The article is for informational purposes only. Please consult with health experts and medical professionals before starting any therapy or medication. Opinions expressed are personal and do not reflect the official position or policy of the Financial Express Online.)