Assessing the Impact of Cellular-Enabled Remote Patient Monitoring for Diabetes Management during Pregnancy on Maternal and Neonatal Clinical Outcomes

Overview Resources

Project Overview

In collaboration with the University of Arkansas Medical Sciences, Type 1 (T1DM) and Type 2 (T2DM) diabetes mellitus during pregnancy effects one out of six live births worldwide and requires intensive glucose monitoring to ensure optimal health outcomes for mothers and infants. Complications due to glycemic variability during pregnancy include hypertension, C-section, preterm birth, stillbirth, cholestasis, neonatal hypoglycemia, macrosomia, and birth defects. Women with T1DM and T2DM have poorer pregnancy outcomes than women without diabetes, including a higher rate of perinatal mortality. For individuals with diabetes, continuous glucose monitoring (CGM) is the best solution for optimizing glycemic control. However, according to the American Diabetes Association, individuals enrolled in Medicaid are two to five times less likely to use CGM then those with commercial health insurance. This gap is greater for people of color using Medicaid when compared with white individuals. For pregnant patients without CGM, standard practice includes a patient monitoring their glucose 4-6 times a day using a standard glucometer and paper diary, discussed with the provider at weekly clinic appointments. Keeping an accurate diary is a challenge for many patients, and weekly clinic visits put a disproportionate burden on patients living in rural areas. Cellular-enabled remote patient monitoring glucometers offer an alternative that reduces the burden on patients while providing real-time glucose readings for medical professionals to ensure optimal glycemic control.

The Institute of Digital Health and Innovation (IDHI) at University of Arkansas for Medical Sciences (UAMS) has nearly 15 years of experience pioneering telemedicine (TM) in a primarily rural state, Arkansas. Our previous pilot study demonstrated high acceptability of the cellular-enabled remote patient monitoring (RPM) iGlucose device. This proposed application aims to focus on barriers and facilitating factors to using the RPM device as well as retrospectively assess the impact that use of the cellular-enabled RPM device had on maternal and neonatal clinical outcomes. Participants will be recruited from the UAMS Women's Center by a trained research associate using charts from EPIC. Inclusion criteria include women enrolled in Medicaid whose pregnancy is complicated by Type 1, Type 2, or Gestational Diabetes, who receive their prenatal care at UAMS Women’s Center and who plan to deliver at UAMS. Participants will complete a baseline self-administered survey which will include demographic characteristics, patient activation, treatment adherence, appraisal of diabetes, technology anxiety, technology facilitating factors, and general health questions. Participants will be asked to use the cellular-enabled remote patient monitoring glucometer for the duration of their pregnancy. After delivery, participants will be asked to complete a post-survey assessing patient activation, treatment adherence, appraisal of diabetes, technology anxiety, technology facilitating factors, system usability, and general health questions as well as a semi-structured exit interview. Maternal and neonatal clinical outcomes will be assessed after delivery using data from the patient’s EPIC chart.


  • The University of Mississippi Medical Center


  • Hari Eswaran, UAMS


  • Active


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