title: Computerized and telemetric management of diabetic pregnancy in Cambridge.
abstract: In order to optimize the quality of our care, we have used the Ames Memory Glucometer in our computerized management of 17 insulin-dependent diabetic pregnancies. Patients measured their own blood glucose levels on 4.5 +/- 1.2 (SD) occasions per day, and six of them transmitted their blood glucose measurements telemetrically from home into a hospital-based computer on a total of 42 occasions. We achieved near-optimal blood glucose levels and normal HbA1 levels throughout most of these 17 pregnancies. Average blood glucose levels were 6.4 +/- 0.9 mmol/l in the first, 5.9 +/- 1.2 mmol/l in the second, 5.4 +/- 1.0 mmol/l in the third trimester. Corresponding values for HbA1 were 8.0 +/- 1.5%, 6.5 +/- 0.8%, and 6.2 +/- 0.4%. Average insulin requirement doubled during pregnancy, but fell to 74% of the pre-pregnancy dosage by one week after delivery. The average gestational age at delivery was 38.9 +/- 1.3 weeks, and we had no perinatal deaths. Two of the babies were macrosomic, even though their mothers had good diabetic control. Four patients were delivered by Caesarean section. However we achieved a vaginal delivery in 93% of those in whom it was planned. Our computerized system of managing diabetic pregnancies was efficient, safe, and popular with our patients.
authors.affiliation: Dept. of Diabetes & Endocrinology, Addenbrooke's Hospital, Cambridge.
authors.forename: H A
authors.initials: HA
authors.lastname: Davies
authors.forename: K J
authors.initials: KJ
authors.lastname: Dalton
authors.forename: J D
authors.initials: JD
authors.lastname: Clark
authors.forename: P
authors.initials: P
authors.lastname: Robarts
authors.forename: D
authors.initials: D
authors.lastname: Juett
authors.forename: O M
authors.initials: OM
authors.lastname: Edwards
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D003201:Computers; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000097:blood*; D013686:Telemetry
chemical_list: D001786:Blood Glucose