Since the onset of the pandemic, pregnant women have been vulnerable to a multitude of health challenges. Access to timely maternal healthcare has been disrupted, with lockdowns and a reduction in the availability of health services contributing to interruptions in regular antenatal checkups.
A recent study conducted by the Indian Council of Medical Research (ICMR) indicates the second wave of COVID-19 infections has been tougher as more pregnant and postpartum women were severely affected than in the first wave. This highlights the urgent need to facilitate and prioritize effective medical care for pregnant women in the country.
The fear of infection, coupled with the non-availability of routine antenatal clinics, continues to prevent expectant mothers from visiting hospitals. Amidst the uncertainty and facing restricted options, pregnant women may have overlooked other health conditions and challenges. One such challenge is gestational diabetes – diabetes during pregnancy – that, when neglected, can have long-lasting, potentially adverse implications for both mother and child.
Due to its increasing prevalence, Gestational Diabetes Mellitus (GDM) is a public health priority in India. It can pose worrying health complications for the mother and child, including risk of low glucose level and pregnancy-related complications, an elevated risk of GDM in future pregnancies, and risk of Type 2 diabetes and cardiovascular complications later in life. With these risks increasing with glycemic variability, effectively managing glucose levels is critical to ensure pregnant women stay in good health. This is even more important now, in the context of COVID-related health and access challenges, to avoid unwanted consequences of poorly controlled diabetes.
The Case For Effective GDM Management
With expectant mothers now experiencing a large part of their pregnancy confined to homes and limited clinic visits, regular monitoring of diabetes may be neglected, with fluctuations in blood sugar levels going unnoticed. This calls for a solution to more effectively monitor one’s condition and inform real-time intervention and management of diabetes.
As it has for patients with Type 1 and Type 2 diabetes, continuous glucose monitoring has heralded a new paradigm of monitoring and management for GDM patients. At a time when our healthcare system is stretched and resources allocated for non-communicable diseases are limited, such technologically innovative, accessible solutions can become a mainstay of effective disease care at home. By enabling early detection, remote care, holistic insights and comprehensive measurement, sensor-based glucose monitors ensure better diabetes management for improved health outcomes in mothers and children.
Sensor-based glucose monitoring devices record glucose levels periodically, rather than at a point in time, as people go about their daily activities. The insights garnered paint a rich picture of glucose level trends, which can detect fluctuations that otherwise go unnoticed. Early detection empowers the mother to seek prompt care to manage glucose levels.
Enabling Remote Care and Holistic Insights for Real-Time Intervention
Testing at home during pregnancy is difficult. Even with a traditional glucometer, the device may not only underestimate the number of hyperglycemic events4 experienced, but also cause pain and hassles due to finger pricking. The alternative of going to a laboratory or clinic is cumbersome in these times of COVID.
Sensor-based devices are an effective option for continuous measurement of glucose levels and they’re easy to use in the comfort of one’s home. Through these devices, information can swiftly be accessed on highs and lows, post meal spikes and even overnight trends. The expecting mother can share this data with her physician, in the form of visual trend charts that can inform clinical decision-making. This enables more effective remote consultation and care, as well as meaningful doctor-patient conversations that aid diabetes management.
Comprehensive Measurement of Gestational Diabetes
Although there are several measures of glucose levels, including postprandial blood sugar (PPBS), fasting blood sugar and HbA1C, these measures are limited to indicating glucose levels at a point in time, or as an average level. Sensor-based glucose monitoring devices offer a unique, vital metric – the time in range (TIR), which measures the time spent by the patient in a target or recommended glucose range. This offers a direct measure of variability in glucose levels, enabling doctors to personalize treatment plans and patients to spend a greater time in range. For pregnant women, TIR can quantitatively measure glycemic control and diabetes management, thus enabling swift real-time interventions to reduce variability and thus improve health outcomes for the mother and unborn child.
Women with GDM face the unique challenge of having to understand the disease, seek treatment and undertake management measures while dealing with the physical and mental changes associated with pregnancy. Within a short span of time, they need to learn to optimize their glucose control and minimize complications associated with gestational diabetes. By tracking glucose levels regularly, they can effectively monitor their condition at home, undergo remote care, act swiftly to prevent variability, and help them get through this pandemic with healthy pregnancy and birth outcomes.
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