Managing Diabetes in Pregnancy Before, During, and After COVID-19
Managing Diabetes in Pregnancy Before, During, and After COVID-19
复制标题
DOI：
10.1089/dia.2020.0223
复制
发表时间：
2020-05-18
影响因子：
5.4
通讯作者：
Murphy, Helen R.
中科院分区：
文献类型：
--
作者：
Murphy, Helen R.
背景：糖尿病孕妇更容易受到COVID-19的严重影响，建议严格遵守社交距离措施。在这里，我们回顾了在封锁之前和期间妊娠糖尿病的管理。方法：大多数产前糖尿病和产科检查都是远程提供的，孕妇只在必要的超声扫描和分娩时到医院诊所就诊。在线资源支持妇女计划怀孕和自我管理的孕妇与1型糖尿病（T1D）使用间歇性或连续血糖监测提供。视网膜筛查程序，分娩时的护理，和封锁对产妇血糖控制的不同影响进行了考虑。讨论了诊断妊娠期高血糖和妊娠期糖尿病（GDM）的替代筛查程序。病例史描述了远程启动胰岛素泵治疗和自动胰岛素输送在T1D妊娠。结果：初步反馈表明，视频会诊很受欢迎，需要面对面就诊的妇女的患者体验大大改善。随着流行病的缓解，对糖尿病远程教育和技术实施模式的正式评价，包括妇女的意见，将是重要的。结论：我们将继续开展研究和审计活动，为支持糖尿病孕妇选择自己喜欢的血糖监测和胰岛素输送找到新的途径。
Background: Pregnant women with diabetes are identified as being more vulnerable to the severe effects of COVID-19 and advised to stringently follow social distancing measures. Here, we review the management of diabetes in pregnancy before and during the lockdown.Methods: Majority of antenatal diabetes and obstetric visits are provided remotely, with pregnant women attending hospital clinics only for essential ultrasound scans and labor and delivery. Online resources for supporting women planning pregnancy and for self-management of pregnant women with type 1 diabetes (T1D) using intermittent or continuous glucose monitoring are provided. Retinal screening procedures, intrapartum care, and the varying impact of lockdown on maternal glycemic control are considered. Alternative screening procedures for diagnosing hyperglycemia during pregnancy and gestational diabetes mellitus (GDM) are discussed. Case histories describe the remote initiation of insulin pump therapy and automated insulin delivery in T1D pregnancy.Results: Initial feedback suggests that video consultations are well received and that the patient experiences for women requiring face-to-face visits are greatly improved. As the pandemic eases, formal evaluation of remote models of diabetes education and technology implementation, including women's views, will be important.Conclusions: Research and audit activities will resume and we will find new ways for supporting pregnant women with diabetes to choose their preferred glucose monitoring and insulin delivery.