Diabetes Advice Just a Phone Call Away

Gestational diabetes patients lower risk of infant with excess weight

(RxWiki News) Pregnancy can be a stressful time, especially if you have diabetes. Support from your partner and family can ease some of that stress.

But maybe women with diabetes during pregnancy need a little more support.

Women with gestational diabetes (diabetes during pregnancy) who are referred to a telephone-based nurse management program may have a lower risk of having an overweight baby.

These women also may be more likely to get blood sugar testing after their baby is born.

"Carefully watch your blood sugar if you are pregnant with diabetes."

Diabetes is difficult enough to deal with on its own. Add pregnancy to the mix and patients are faced with a whole new set of potential problems, including high blood pressure, continuing diabetes, an overweight baby and other health problems affecting the newborn.

Assiamira Ferrara, MD, PhD, of Kaiser Permanente Northern California Division of Research, and colleagues wanted to see if women with gestational diabetes had better outcomes when they were referred to a telephonic nurse management program.

Dr. Ferrara and colleagues compared outcomes of women at 12 Kaiser Permanente medical centers where the rate of referral to nurse management was either less than 30 percent or more than 70 percent. They studied the relationship between referrals and outcomes.

The researchers found that women with gestational diabetes at centers where the referral rate was more than 70 percent were less likely to have a macrosomic (excess weight) infant and more likely to have blood sugar testing after giving birth, compared to women at centers with a referral rate of less than 30 percent.

It is important for women with gestational diabetes to get blood sugar testing after giving birth because gestational diabetes can lead to future Type 2 diabetes.

According to Dr. Ferrara, blood sugar testing of the mother after birth can lead to earlier identification of glucose (sugar) intolerance and diabetes.

"The Kaiser Permanente Regional Perinatal Service Center is a nurse-based management program for women with [gestational diabetes] that offers supplemental care via telephone counseling to women with high-risk pregnancies, including those complicated by [gestational diabetes]," explains study co-author Monique Hedderson, PhD, of Kaiser Permanente Northern California Division of Research.

The telephone-based nurse management program gives patients access to 32 nurses and two dietitians who offer guidance on issues like blood sugar control, diet and exercise. The call center is open 24 hours a day, seven days a week. However, the dietitians are only available on weekdays between 8 a.m. and 5 p.m.

On top of their regular care from an obstetrician, women participating in the program get one or two calls per week to help them with blood sugar management. After a woman gives birth, the center sends her a slip for testing blood sugar.

If the center does not receive results from the test, it gives patients a call to remind them.

For their study, the researchers looked at data from the Kaiser Permanente Northern California Gestational Diabetes Mellitus registry to identify women who were pregnant with gestational diabetes between 1997 and 2006. More than 11,000 women with gestational diabetes were identified.

The study was funded by the Translating Research into Action for Diabetes study, which received its funding from the Centers for Disease Control and Prevention and the National Institute of Diabetes and Digestive and Kidney Diseases.

The results are published in the American Journal of Obstetrics and Gynecology.

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Review Date: 
May 25, 2012