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Impact of clinical pharmacist intervention on blood glucose control and perinatal outcomes in gestational diabetes mellitus through a diabetes management system |
C. Ji1, L.J. Sun2, L.T. Li1, J. Ma1, W.H. Ge1, *( ), X. Zhao3, *( ) |
1Department of Pharmacy, Affiliated Drum Tower Hospital, Medical School of Nanjing University, No.321 Zhongshan Road, Nanjing, P.R. China 2Department of Endocrinology, Sir Run Run Hospital, Nanjing Medical University, No.109 Longmian Road, Nanjing, P.R. China 3The Pharmaceutical college of Inner Mongolia medical university, No.5 XinHua Street, Hohhot, P.R. China |
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Abstract Background: Very few studies have assessed the role of a clinical pharmacist in women with gestational diabetes mellitus (GDM). To improve pharmaceutical care, we explored a method to improve the control of blood glucose and perinatal outcomes in females with GDM through the application of a diabetes management system. Methods: A randomized controlled trial was conducted from October 2017 to October 2018 for 200 outpatients with GDM. In the study, a diabetes management system with pharmaceutical care was used for the intervention group. The clinical outcomes of all patients were recorded at the end of delivery. Results: From one sample of 200 patients, 169 finished the research. Compared with the control group, patients in the intervention group manifested greater reductions in fasting plasma glucose (5.22 ± 0.37 vs. 6.05 ± 1.06 mmol/L; P = 0.018), 2 h postprandial plasma glucose (6.66 ± 0.57 vs. 9.69 ± 1.58 mmol/L; P = 0.00), and glycated hemoglobin A1c corrected values (1.02 ± 0.12 vs. 1.16 ± 0.22; P = 0.023). Moreover, the rate of polyhydramnios was significantly lower in the intervention group than in the control group (0% vs. 10.59%; P = 0.003) as well as significantly fewer macrosomia in the intervention group (7.14% vs. 18.82%; P = 0.038). Conclusions: Using a diabetes management system, clinical pharmacists can improve the control of blood glucose and perinatal results in GDM females. With a diabetes management system, the comprehensive management of GDM is a new model for pharmaceutical care in the future.
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Submitted: 06 July 2020
Accepted: 31 August 2020
Published: 15 October 2020
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Fund: 2018YX010/Nanjing Pharmaceutical Association, Changzhou Four Hospital |
*Corresponding Author(s):
W.H. Ge,X. Zhao
E-mail: 6221230@sina.com;amy-zhaoxue@126.com
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[1] |
Metzger B.E., Coustan D.R.: “Summary and recommendations of the Fourt International Workshop-Conference on Gestational Diabetes Mellitus”. Diabetes Care. 1998, 21, 161-167.
|
[2] |
Zhang F., Dong L., Zhang C.P., Li B., Wen J., Gao W., et al.: “Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008”. Diabet. Med., 2011, 28, 652-657.
doi: 10.1111/j.1464-5491.2010.03205.x
pmid: 21569085
|
[3] |
Pridjian G., Benjamin, T.D.: “Update on gestational diabetes”. Obstet. Gyn. Clin. N. Am., 2010, 37, 255-267.
doi: 10.1016/j.ogc.2010.02.017
|
[4] |
Kim C., Newton K.M., Knopp R.H.: “Gestational diabetes and the incidence of type 2 diabetes: A systematic review”. Diabetes Care, 2002, 25, 1862-1868.
doi: 10.2337/diacare.25.10.1862
pmid: 12351492
|
[5] |
Barquiel B., Herranz L., Hillman N., Burgos M.Á., Grande C., Tukia K.M., et al.: “HbA1c and gestational weight gain are factors that influence neonatal outcome in mothers with gestational diabetes”. J. Women Health (Larchmt), 2016, 25, 579-585.
doi: 10.1089/jwh.2015.5432
|
[6] |
Rayanagoudar G., Hashi A.A., Zamora J., Khan K.S., Hitman G.A., Thangaratinam S., et al.: “Quantification of the type 2 diabetes risk in women with gestational diabetes: a systematic review and meta-analysis of 95,750 women”. Diabetologia, 2016, 59, 1403-1411.
doi: 10.1007/s00125-016-3927-2
pmid: 27073002
|
[7] |
Crowther C.A., Hiller J.E., Moss J.R., McPhee A.J., Jeffries W.S., Robinson J.S., et al: “Effect of treatment of gestational diabetes mellitus on pregnancy outcomes”. N. Engl. J. Med., 2005, 352, 2477-2486.
doi: 10.1056/NEJMoa042973
pmid: 15951574
|
[8] |
Landon M.B., Spong C.Y., Thom E., Carpenter M.W., Ramin S.M., Casey B., et al.: “A multicenter, randomized trial of treatment for mild gestational diabetes”. N. Engl. J. Med., 2009, 361, 1339-1348.
doi: 10.1056/NEJMoa0902430
pmid: 19797280
|
[9] |
NCC-WCH.: “Diabetes in Pregnancy: management of diabetes and Its Complications from Preconception to the postnatal period”. 2008.
|
[10] |
Choudhry N.K., Isaac T., Lauffenburger J.C., Gopalakrishnan C., Lee M., Vachon A., et al.: “Effect of a remotely delivered tailored multicomponent approach to enhance medication taking for patients with hyperlipidemia, hypertension, and diabetes: the stic2it cluster randomized clinical trial”. JAMA Intern. Med., 2018, 178, 1182-1189.
doi: 10.1001/jamainternmed.2018.3189
pmid: 30083727
|
[11] |
Fazel M.T., Bagalagel A., Lee J.K., Martin J.R., Slack M.K.: “Impact of diabetes care by pharmacists as part of health care team in ambulatory settings: a systematic review and meta-analysis”. Ann. Pharmacother., 2017, 51, 890-907.
doi: 10.1177/1060028017711454
pmid: 28573873
|
[12] |
Emet T., Ustner I., Given S.G., Balık G., Ural Ü.M., Tekin Y.B., et al.: “Plasma lipids and lipoproteins during pregnancy and related pregnancy outcomes”. Arch. Gynecol. Obstet., 2013, 288, 49-55.
doi: 10.1007/s00404-013-2750-y
|
[13] |
Metzger B.E., Contreras M., Sacks D.A., Watson W., Dooley S.L., Foderaro M., et al.: “Hyperglycemia and adverse pregnancy outcomes”. N. Engl. J. Med., 2008, 358, 1991-2002.
doi: 10.1056/NEJMoa0707943
pmid: 18463375
|
[14] |
HAPO.: “The HAPO Study Cooperative Research Group Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: associations with neonatal anthropometrics”. Diabetes, 2009, 58, 453-459.
doi: 10.2337/db08-1112
pmid: 19011170
|
[15] |
Sosenko I.R., Kitzmiller J.L., Loo S.W., Blix P., Rubenstein A.H., Gabbay K.H., et al.: “The infant of the diabetic mother: correlation of increased cord C-peptide levels with macrosomia and hypo- glycemia”. N Engl J. Med., 1979, 301, 859-862.
doi: 10.1056/NEJM197910183011603
pmid: 481527
|
[16] |
Ong K.K., Diderholm B., Salzano G., Wingate D., Hughes I.A., MacDougall J. et al.: “Pregnancy insulin, glucose, and BMI contribute to birth outcomes in nondiabetic mothers”. Diabetes Care, 2008, 31, 2193-2197.
doi: 10.2337/dc08-1111
pmid: 18697902
|
[17] |
Manderson J.G., Mullan B., Patterson C.C., Hadden D., Traub A., McCance D., et al.: “Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy”. Diabetologia., 2002, 45, 991-996.
doi: 10.1007/s00125-002-0865-y
pmid: 12136397
|
[18] |
Reece E.A., Homko C.J.: “Assessment and management of pregnancies complicated by pregestational and gestational diabetes mellitus”. J. Assoc. Acad. Minor. Phys., 1994, 5, 87-97.
pmid: 7949826
|
[19] |
De Veciana M., Morgan M.A., Major C.A.: “Blood glucose monitoring in gestational diabetes mellitus”. N. Engl. J. Med., 1996, 334, 599-602.
doi: 10.1056/NEJM199602293340913
pmid: 8569837
|
[20] |
Kilpatrick E.S., Rigby A.S., Atkin S.L.: “Variability in the relationship between mean plasma glucose and HbA1c: Implications for the assessment of glycemic control”. Clin. Chem., 2007, 53, 897-901.
doi: 10.1373/clinchem.2006.079756
pmid: 17384010
|
[21] |
Leipold H., Worda C., Ozbal A., Husslein P., Krampl E.: “First- trimester nuchal translucency screening in pregnant women who subsequently developed gestational diabetes”. J. Soc. Gynecol. Invest., 2005, 12, 529-532.
doi: 10.1016/j.jsgi.2005.05.003
|
[22] |
Balaji V., Madhuri B.S., Ashalatha S., Sheela S., Suresh S., Seshiah V., et al.: “A1c in gestational diabetes mellitus in Asian Indian women”. Diabetes Care, 2007, 30, 1865-1867.
doi: 10.2337/dc06-2329
pmid: 17416790
|
[23] |
Sapienza A.D., Francisco R.P., Trindade T.C., Zugaib M.: “Factors predicting the need for insulin therapy in patients with gestational diabetes mellitus”. Diabetes Res. Clin. Pract., 2010, 88, 81-86.
doi: 10.1016/j.diabres.2009.12.023
pmid: 20071050
|
[24] |
Bakiner O., Bozkirli E., Ozsahin K., Sariturk C., Ertorer E.: “Risk factors that can predict antenatal insulin need in gestational diabetes”. J. Clin. Med. Res., 2013, 5, 381-388.
doi: 10.4021/jocmr1515w
pmid: 23976911
|
[25] |
China Adult Dyslipidemia Prevention Guide Committee.: “China adult dyslipidemia prevention guide”. Chin. J. Cardiol., 2007, 35, 390-420.
|
[26] |
Mankuta D., Lami-Suzin M., Elhayani A., Vinker S.: “Lipid profile in consecutive pregnancies”. Lipids Health Dis., 2010, 9, 58-62.
doi: 10.1186/1476-511X-9-58
pmid: 20525387
|
[27] |
Neboh E.E., Emeh J.K., Aniebue U.U., Ikekpeazu E.J., Maduka I.C., Ezeugwu F.O.: “Relationship between lipid and lipoprotein metabolism in trimesters of pregnancy in Nigerian women: Is pregnancy a risk factor?”. J. N. at SciBiol. Med., 2012, 3, 32-37.
|
[28] |
Santschi V., Chiolero A., Colosimo A.L., et al.: “Improving blood pressure control through pharmacist interventions: a meta‐analysis of randomized controlled trials”. J. Am. Heart. Assoc., 2014, 3, e000718.
doi: 10.1161/JAHA.113.000718
pmid: 24721801
|
[29] |
Reece E.A., Coustan D.R., Gabbe D.G.: “Obstetric complications in diabetic pregnancies”. Diabetes in Woman, 2004, 353-354.
|
[30] |
McMahon M.G., Ananth C.V., Liston R.W.: “Gestational diabetes mellitus. Risk factors, obstetric complications and infant outcomes”. J. Report. Med., 1998, 43, 327-378.
|
[31] |
Said A.S., Manji K.P.: “Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: a case-control study”. BMC Pregnancy and Childbirth, 2016, 16, 243.
doi: 10.1186/s12884-016-1044-3
pmid: 27557930
|
[32] |
He X.J., Qin F.Y., Hu C.L., Zhu M., Tian C.Q., Li L., et al.: “Is gestational diabetes mellitus an independent risk factor for macrosomia: a meta-analysis?”. Arch. Gynecol. Obstet., 2015, 291, 729-735.
doi: 10.1007/s00404-014-3545-5
pmid: 25388922
|
[33] |
Fan Z.T., Yang H.X., Gao X.L., Lintu H., Sun W.J.: “Pregnancy outcome in gestational outcomes”. Int. J. Gynecol. Obstet., 2006, 94, 12-16.
doi: 10.1016/j.ijgo.2006.03.021
|
[34] |
Langer O.: “Fetal macrosomia: etiologic factor”. Clin Obstet Gynecol., 2000, 43, 283-297.
doi: 10.1097/00003081-200006000-00006
pmid: 10863626
|
[35] |
Combs C.A., Gunderson E., Kitzmiller J.L., Gavin L.A., Main E.K.: “Relationship of fetal macrosomia to maternal postparandial glucose control during pregnancy”. Diabetes Care, 1992, 15, 1251-1257.
doi: 10.2337/diacare.15.10.1251
pmid: 1425084
|
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