New diabetes program connects pregnant patients and providers using cellular-enabled glucose meter

Erin Guthrie
Erin Guthrie has been managing Type 2 diabetes since the birth of her first child.

Erin Guthrie was expecting a new baby, not diabetes.

The Cedar Rapids resident developed gestational diabetes during her first pregnancy and has been managing Type 2 diabetes since her daughter was born in 2013.

So when Erin learned she was pregnant with her second child in September 2015, she immediately scheduled an appointment to receive high-risk pregnancy care at University of Iowa Hospitals & Clinics.

For the first six weeks of her second pregnancy, Erin managed her diabetes traditionally–giving herself insulin injections and checking glucose levels several times a day, tracking her numbers manually, and calling the clinic to report her results.

“It was already starting to be a struggle to take care of myself along and all of my other responsibilities,” Erin says.

As with many women living with this condition, diabetes is just one of the pins in Erin’s juggling act. She’s busy raising her 2-year-old daughter, working 40 hours a week, caring for her elderly mother, and serving in the Army Reserve.

For women like Erin, the UI Department of Obstetrics and Gynecology has launched new a service that makes it more convenient for pregnant women with diabetes to communicate with their obstetric providers. Patients are given an advanced blood glucose meter that automatically sends results to their care team. No manual tracking is necessary.

“The meter is an FDA-approved device that allows us to see the patient’s blood glucoses in real time,” says Janet Andrews, MD, a maternal and fetal medicine specialist in the UI Department of Obstetrics and Gynecology. “This also gives us the opportunity to make necessary, timely changes to the patient’s medication plan.”

The cellular-enabled TelCare® device does not require patients to have a data plan. Through this Health Insurance Portability and Accountability Act (HIPAA)-secured system, the care team can provide instant feedback and coaching to patients by texting the glucose meter itself, calling by phone, or sending messages via MyChart, a Web-based service that gives UI Health Care patients instant access to their personal health information.

“To hear feedback not only from the meter but directly from my provider makes me feel more connected and comfortable,” says Erin.
glucose meter

The meter also allows patients to give loved ones access to their personal online portal. For Erin, this feature allows her husband, Robert, who travels five days a week, and her sister in California to feel more connected to her pregnancy.

“We believe that individuals who maintain regular remote contact with their health care provider and receive ongoing self-management and decision support will have fewer unscheduled clinic visits, fewer emergency department visits, fewer hospitalizations, and will achieve better overall glycemic control,” says Diedre Fleener, the Diabetes During Pregnancy Program’s nurse coordinator. “This is a population where we can show a significant impact in improving the health and outcomes of the pregnant mother and her unborn child.”

The Centers for Disease Control and Prevention says pregnant women who have diabetes are at an increased risk for preterm labor, high blood pressure, cesarean section, and other complications caused by diabetes. Babies born to women with uncontrolled diabetes are at an increased risk for birth defects, low blood sugar after birth, excessive weight, and stillbirth.

“I like that it’s just one diabetic nurse and one doctor focused on my diabetic care,” Erin says. “You get that one-on-one, patient-led care with this program.”

For more information on high-risk pregnancy services available through the UI Women’s Health Center, visit uihealthcare.org/highriskpregnancy or call 319-356-2294.

EDITOR’S NOTE: Erin gave birth to a baby boy on May 16, 2016. She and the baby are doing well.

— Lindsay Douglas
Spring/Summer 2016