Patient compliance and satisfaction using web-based glucose monitoring for the management of pregnant women with pregestational diabetes

Abstract

Background

Optimal glycemic control is vital in decreasing the risk of congenital birth defects and perinatal complications in women with diabetes. Although frequent blood glucose (BG) monitoring is essential during pregnancy, studies have highlighted poor compliance and falsification of glucose readings. We designed this study to assess whether a web-based glucose monitor improves compliance, glycemic control, and patient satisfaction.

Methods

This was a prospective study of 30 women with pre-gestational diabetes. After 4 weeks of using paper logs, patients were given a web-based glucose monitor. The primary outcome of interest was the average number of BG readings prior to and during web-based implementation. Secondary outcomes included glycemic control and patient satisfaction as determined by a pre- and post-study survey.

Results

The number of BG readings after 2 months using the web-based meter was similar to baseline. Hemoglobin A1c (HbA1c) significantly improved and there was a trend toward improved overall glycemic values. Survey results demonstrated satisfaction with the new system, although 20% of patients felt uncomfortable with glucose values being available to providers in real time.

Conclusions

Compliance with BG monitoring was similar when comparing a web-based system with written logs. Since other studies have highlighted that some glucose data from written logs are falsified, actual compliance using the web-based monitor may be improved. This study demonstrates potential patient concerns using a web-based system. Further studies should explore patient reactions to providers having real-time access to online glycemic data given our survey results.

Keywords:

• Patient compliance
• patient satisfaction
• pregestational diabetes
• web-based glucose monitoring

Acknowledgements

The authors wish to acknowledge the clinical help Christine Hricak, CMA (AAMA) provided during the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding sources: Pool Research Grant, Allentown PA USA, American Osteopathic Foundation, Chicago IL, USA.