Tele-Mum: A Feasibility Study for a Randomized Controlled Trial Exploring the Potential for Telemedicine in the Diabetes Care of Those with Gestational Diabetes

Joanne Given, Brendan Bunting, Maurice J. O'Kane, Fidelma Dunne, Vivien Coates

Research output: Contribution to journalArticlepeer-review

26 Citations (Scopus)


BACKGROUND:The incidence of gestational diabetes mellitus (GDM)--hyperglycemia with onset or first recognition during pregnancy--is increasing and will have a significant impact on diabetes services. This study aimed to determine the feasibility and acceptability of using telemedicine in the diabetes care of women with GDM and the possibility of replacing alternate (one in every two) diabetes review appointments with telemedicine.SUBJECTS AND METHODS:A feasibility study for a randomized controlled trial was conducted across two sites. Fifty women with GDM were randomized to usual care (n = 26) or usual care plus telemedicine (n = 24). Telemedicine entailed weekly blood pressure and weight measurements and transmission of these data, along with blood glucose readings, for review by the healthcare team. Patients were contacted about these results as necessary. Patients completed questionnaires to measure their satisfaction with telemedicine or blood glucose monitoring. The intervention group and healthcare providers also took part in qualitative interviews. Analysis involved descriptive statistics for the satisfaction questionnaires and framework analysis for the qualitative interviews.RESULTS:Eighty-nine percent of patients were satisfied with telemedicine and would use it again. Both HCPs and patients found the equipment easy to use and were positive about using it to replace alternate diabetes review appointments in the future. If used in this way, healthcare providers felt that protected time in which to perform the telemedicine review would be necessary.CONCLUSIONS:Telemedicine may help meet the growing demand on diabetes services due to increasing numbers of women being diagnosed with GDM.
Original languageEnglish
Pages (from-to)880-888
JournalDiabetes Technology and Therapeutics
Issue number12
Early online date22 Sep 2015
Publication statusPublished - 30 Nov 2015

Bibliographical note

Reference text: 1. World Health Organization. Diabetes Fact sheet N°312. 2011;2012(10/01).
2. National Institute of Clinical Excellence. Diabetes in Pregnancy: Management of Diabetes and Its Complications from Pre-Conception to the Postnatal Period.; 2008.
3. Landon MB, Catalano PM, Gabbe SG. Diabetes mellitus complicating pregnancy. In: Gabbe SG, Niebyl JR, Simpson JL, et al., eds. Obstetrics: Normal and Problem Pregnancies.Vol 6th. Philadelphia: Elsevier; 2012:887-921.
4. Crowther CA, Hiller JE, Moss JR, et al. Effect of Treatment of Gestational Diabetes Mellitus on Pregnancy Outcomes. N Engl J Med. 2005;352(24):2477.
5. Saudek CD, Derr RL, Kalyani RR. Assessing glycemia in diabetes using self-monitoring blood glucose and hemoglobin A1c. J Am Med Assoc. 2006;295(14):1688-1697.
6. Moses RG. New consensus criteria for GDM: problem solved or a Pandora’s box? Diabetes Care. 2010;33(3):690-691. doi:10.2337/dc09-2306.
7. Organization WH. Telemedicine: Opportunities and Developments in Member States Report on the Second Global Survey on eHealth. Geneva: World Health Organization; 2010.
8. Mastrogiannis DS, Igwe E, Homko CJ. The role of telemedicine in the management of the pregnancy complicated by diabetes. Curr Diab Rep. 2013;13(1):1-5.<author>Mastrogiannis+DS.
9. Roine R, Ohinmaa A, Hailey D. Assessing telemedicine: a systematic review of the literature. Can Med Assoc J. 2001;165(6):765-771.
10. Bashshur RL, Reardon TG, Shannon GW. Telemedicine: a new health care delivery system. Annu Rev Public Health. 2000;21(1):613-637.
11. Magann EF, McKelvey SS, Hitt WC, et al. The use of telemedicine in obstetrics: a review of the literature. Obstet Gynecol Surv. 2011;66(3):170-178.<author>Magann+E.F.
12. Bergenstal RM, Anderson RL, Bina DM, et al. Impact of modem-transferred blood glucose data on clinician work efficiency and patient glycemic control. Diabetes Technol Ther. 2005;7(2):241-247.
13. Verhoeven F, Tanja-Dijkstra K, Nijland N, et al. Asynchronous and synchronous teleconsultation for diabetes care: a systematic literature review. J Diabetes Sci Technol. 2010;4(3):666-684.
14. Wojcicki JM, Ladyzynski P, Krzymien J, et al. What can we really expect from telemedicine in intensive diabetes treatment: Results from 3-year study on type 1 pregnant diabetic women. Diabetes Technol Ther. 2001;3(4):581-589.
15. Paré G, Jaana M, Sicotte C. Systematic review of home telemonitoring for chronic diseases: the evidence base. J Am Med Informatics Assoc. 2007;14(3):269-277.
16. Chase HP, Roberts MD, Pearson JA, et al. Modem transmission of glucose values reduces the costs and need for clinic visits. Diabetes Care. 2003;26(5):1475-1479.
17. Kruger DF, White K, Galpern A, et al. Effect of modem transmission of blood glucose data on telephone consultation time, clinic work flow, and patient satisfaction for patients with gestational diabetes mellitus. J Am Acad Nurse Pract. 2003;15(8):371-375.
18. Calle-Pascual AL, Perez-Ferre N, Galindo M, et al. The outcomes of gestational diabetes mellitus after a telecare approach are not inferior to traditional outpatient clinic visits. Int J Endocrinol. 2010;2010. doi:10.1155/2010/386941.
19. Benger J, Noble S, Coast J, et al. The safety and effectiveness of minor injuries telemedicine. Emerg Med J. 2004;21(4):438-445.
20. Biermann E, Dietrich W, Rihl J, et al. Are there time and cost savings by using telemanagement for patients on intensified insulin therapy?: A randomised, controlled trial. Comput Methods Programs Biomed. 2002;69(2):137-146.
21. Tachakra S, Lynch M, Newson R, et al. A comparison of telemedicine with face-to-face consultations for trauma management. J Telemed Telecare. 2000;6(S1):178-181.
22. Biermann E, Dietrich W, Standl E. Telecare of diabetic patients with intensified insulin therapy. A randomized clinical trial. Stud Health Technol Inform. 2000;77:327-332.
23. The Lewin Group I. Assessment of Approaches to Evaluating Telemedicine. Online: Department of Health and Human Resources; 2000.
24. Shea S, Weinstock RS, Starren J, et al. A randomised trial comparing telemedicine case management with usual care in older, ethnically diverse, medically underserved patients with diabetes mellitus. J Am Med Informatics Assoc. 2006;13(1):40-51.
25. Bakken S, Grullon-Figueroa L, Izquierdo R, et al. Development, Validation, and Use of English and Spanish Versions of the Telemedicine Satisfaction and Usefulness Questionnaire. J Am Med Informatics Assoc. 2006;13(6):660-667.
26. Torgerson DJ, Torgerson CJ. Pilot randomised controlled trials. In: Designing Randomised Trials in Health, Education and the Social Sciences. Hampshire: Palgrave Macmillan; 2008:119-126.
27. Saghaei M. Random allocation software for parallel group randomized trials. BMC Med Res Methodol. 2004;4:26. doi:10.1186/1471-2288-4-26.
28. Smith J, Firth J. Qualitative data analysis: the framework approach. Nurse Res. 2011;18(2):52-62.
29. Ritchie J, Spencer L, O’Connor W. Carrying out qualitative analysis. In: Ritchie J, Lewis J, eds. Qualitative Research Practice: A Guide for Social Science Students and Researchers. London: SAGE Publications; 2003:219-262.
30. World Health Organization. A Health Telematics Policy in Support of WHO’s Health-For-All Strategy for Global Health Development: Report of the WHO Group Consultation on Health Telematics, 11-16 December, Geneva, 1997. Geneva: World Health Organization; 1998.
31. Whitten P, Love B. Patient and provider satisfaction with the use of telemedicine: Overview and rationale for cautious enthusiasm. J Postgrad Med. 2005;51(4):294-300.
32. Collins K, Walters S, Bowns I. Patient satisfaction with teledermatology: quantitative and qualitative results from a randomized controlled trial. J Telemed Telecare. 2004;10(1):29-33. doi:10.1258/135763304322764167.
33. Central Statistics Office. Household Budget Survey 2009-2010. Dublin: Stationary Office; 2012.
34. Ofcom Research. 1.3 Communications Service Adoption Across the Nations of the UK: 2011. 2013;(07/01).
35. Palmas W, Teresi J, Weinstock RS, et al. Acceptability to primary care providers of telemedicine in diabetes case management. J Telemed Telecare. 2008;14(6):306-308.
36. Mooi JK, Whop LJ, Valery PC, et al. Teleoncology for indigenous patients: the responses of patients and health workers. Aust J Rural Health. 2012;20(5):265-269.<author>Mooi+JK.
37. Gagnon MP, Duplantie J, Fortin JP, et al. Implementing telehealth to support medical practice in rural/remote regions: what are the conditions for success? Implement Sci. 2006;1(18):11 January 2013. doi:10.1186/1748-5908-1-18.
38. Jarvis-Selinger S, Chan E, Payne R, et al. Clinical telehealth across the disciplines: lessons learned. Telemed e-Health. 2007;14(7):720-725.
39. Richards H, King G, Reid M, et al. Remote working: survey of attitudes to eHealth of doctors and nurses in rural general practices in the United Kingdom. Fam Pract. 2005;22(1):2-7.<author>Richards+H.
40. May C, Harrison R, Finch T, et al. Understanding the normalization of telemedicine services through qualitative evaluation. J Am Med Informatics Assoc. 2003;10(6):596-604. doi:10.1197/jamia.M1145.
41. Neville RG, Greene AC, Lewis S. Patient and health care professional views and experiences of computer agent-supported health care. Inform Prim Care. 2006;14(1):11-15.<author>Neville+R.G.
42. Pols J. The heart of the matter. About good nursing and telecare. Heal Care Anal. 2010;18(4):374-388.<author>Pols+J.
43. Hopp FP, Hogan M. Community-based tele-health systems for persons with diabetes: development of an outcomes model. Soc Work Health Care. 2009;48(2):134-153.
44. Istepanian RS, Zitouni K, Harry D, et al. Evaluation of a mobile phone telemonitoring system for glycaemic control in patients with diabetes. J Telemed Telecare. 2009;15(3):125-128.
45. Currell R, Urquhart C, Wainwright P, et al. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes (Review). Cochrane Database Syst Rev. 2000;(2):CD002098. doi:10.1002/14651858.CD002098.
46. Mair F, Whitten P. Systematic review of studies of patient satisfaction with telemedicine. Br Med J. 2000;320:1517-1520.


  • Gestational Diabetes
  • Telemedicine
  • Feasibility study
  • Randomised Controlled Trial.


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