Diabetes Management Delivery and Pregnancy Outcomes in Women with Gestational Diabetes Mellitus during the First Wave of the 2020 COVID-19 Pandemic: A Single-Reference Center Report.

Magdalena Wilk,Paulina Surowiec,Albert Wróbel,Hubert Huras,Katarzyna Cyganek,Bartłomiej Matejko,Maciej T Małecki,Joanna Zięba-Parkitny,Carlos Martinez Salgado

doi:10.1155/2021/5515902

Magdalena Wilk, Paulina Surowiec + Show 7 more

Open Access

https://doi.org/10.1155/2021/5515902

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Abstract

Objectives The COVID-19 pandemic has forced a rapid adaptation of healthcare services to secure care for many patient groups. This includes women with gestational diabetes mellitus (GDM). We evaluated the impacts of the first COVID-19 wave on parameters such as the GDM treatment, glycemic control, and pregnancy outcomes. Methods In this retrospective study from a reference diabetes center (Krakow, Poland), we compared patient data from two different time periods: the first wave of the COVID-19 pandemic (March 2020–June 2020) and the preceding five months (October 2019–February 2020). Data was collected from the medical records and telephone surveys. Results We included 155 consecutive women (group N1 = 73 and group N2 = 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively). During the COVID-19 pandemic, almost half of all GDM women (N1 = 36, 49.3%) used telemedicine as a method of contacting their diabetic specialists while this tool was not utilized in the earlier period. Moreover, these patients reported difficulties in performing blood glucose self-control more often (N1 = 20, 27.4%, vs N2 = 7, 8.5%; p ≤ 0.01) and spent less time on diabetes education than the control group on average (N1 = 39, 53.4%, vs N2 = 9, 9.8% below 2 hours of training; p ≤ 0.01). Most analyzed glycemic parameters and pregnancy outcomes were similar. Differences were found with respect to the incidence of prolonged labor (N1 = 12, 16.4%, vs N2 = 3, 3.7%; p ≤ 0.01) and preeclampsia (N1 = 0 vs N2 = 7, 8.5%; p = 0.01). Conclusion In this single-center observational study, the first wave of the COVID-19 pandemic did not seem to have a negative impact on pregnancy outcomes in GDM women, despite the difficulties in diabetes management delivery.

Highlights

A novel SARS-CoV 2 virus and the resulting disease known as COVID-19 emerged in Wuhan, China, in December 2019 [1]
The key element of diabetes care is to educate on diet, self-monitoring of blood glucose (SMBG), and even insulin injections if needed [5]
We aimed to evaluate the impact of the first wave of COVID-19 of the 2020 pandemic on the gestational diabetes mellitus (GDM) treatment, glycemic control, and pregnancy outcomes

Summary

Introduction

A novel SARS-CoV 2 virus and the resulting disease known as COVID-19 emerged in Wuhan, China, in December 2019 [1]. The COVID-19 pandemic required the rapid transformation and adaptation of healthcare services worldwide to Journal of Diabetes Research secure appropriate medical care for many patient groups [3]. This includes women with gestational diabetes mellitus (GDM). This condition is the most common medical complication of pregnancy and causes high-risk pregnancies [4]. Patients diagnosed with GDM are potentially at a higher risk for a severe COVID-19 infection due to predisposing factors such as hyperglycemia, frequent concomitant obesity, and hypertension. These patients have a higher association of an increased risk of hospitalization and acute respiratory distress syndrome (ARDS) secondary to a SARS-CoV2 infection [11, 12]

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