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

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 N 1 = 73 and group N 2 = 82 from the COVID-19 pandemic period and non-COVID-19 period, respectively). During the COVID-19 pandemic, almost half of all GDM women ( N 1 = 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 ( N 1 = 20 , 27.4%, vs N 2 = 7 , 8.5%; p ≤ 0.01 ) and spent less time on diabetes education than the control group on average ( N 1 = 39 , 53.4%, vs N 2 = 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 ( N 1 = 12 , 16.4%, vs N 2 = 3 , 3.7%; p ≤ 0.01 ) and preeclampsia ( N 1 = 0 vs N 2 = 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.

Cardio-Metabolic and Mental Health Outcomes Before and During the COVID-19 Pandemic in a Cohort of Women With Gestational Diabetes Mellitus in Switzerland

“…However, in our cohort, obstetric and neonatal adverse outcomes including caesarean delivery, prematurity and particularly SGA and LGA potentially related to an increase in stress or decrease in physical activity, were not different. This is in line with two previous studies that did not find worsened perinatal complications in women with GDM during the pandemic ( 21 , 22 ). Importantly, the pandemic was also not associated with any increase in adverse mental health outcome during pregnancy in our cohort.…”

“…Only two studies have investigated glycemic control during pregnancy in the pandemic and the results are controversial. Whereas one showed no differences in glycemic parameters in GDM women before and during the pandemic ( 21 ), another study that reported lower glucose control and an increased need for insulin treatment during pregnancy in women with GDM during the pandemic, is consistent with our result ( 23 ). Our findings could be explained by the decreased physical activity during the lockdown.…”

“…Only few data exist regarding the impact of COVID-19 on outcomes of women with GDM. In contrast to the general pregnant population, the pandemic did not lead to an increase in perinatal complications in women with GDM (21,22). One recent qualitative study that performed phone interviews in 11 women with previous GDM during the pandemic reported negative feelings of loneliness, breastfeeding uncertainties and worries about the infant's well-being and the risk of type-2 diabetes (16).…”

“…There are no quantitative studies regarding their mental health outcomes. Data about glycemic control in GDM is conflicting: while one retrospective study found worsened glucose control during pregnancy ( 23 ), another did not ( 21 ).…”

Changes in screening, diagnosis, management, and outcomes of gestational diabetes during the COVID-19 pandemic: A systematic review

“…This condition typically emerges around the 24th to 28th week of gestation and if not managed appropriately, it can lead to various health complications for both mother and baby [ 1 ] including neonatal hypoglycemia, macrosomia, preeclampsia, preterm delivery, and polyhydramnios [ 6 ]. The International Diabetes Federation has reported its prevalence as being more than 14.0 % in 2017 and this included approximately 21.3 million live births [ [7] , [8] , [9] ]. Changes in the blood glucose of pregnant women with gestational diabetes should be reported immediately to a healthcare professional [ 6 ].…”