The effectiveness of using telemedicine on blood sugar control and maternal complications and neonatal outcomes of women with gestational diabetes during covid-19: a quasi-experimental study

Document Type : Original Article


1 Assistant Professor of Neonatal-Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

2 M.Sc. of Anatomical Sciences, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Assistant Professor, Department of Anesthesiology, Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.


Introduction: Women with high-risk pregnancies, including women with gestational diabetes, are much more prone to COVID-19 than other pregnant women, so the use of telemedicine programs is very necessary for these women in self-care of their disease during the Covid-19 pandemic; Therefore, the present study was performed with aim to determine the effectiveness of using telemedicine on blood sugar control and maternal complications and neonatal outcomes of women with gestational diabetes during covid-19.
Methods: This quasi-experimental study was conducted with the participation of 88 women with gestational diabetes in Taleghani Hospital, Tabriz in 2020-2021. The participants were randomly assigned to two groups of intervention (use of telemedicine technology) and control (conventional method). Weight control, blood sugar, maternal complications and neonatal outcomes were compared between the two groups. Data analysis was done using SPSS statistical software (version 25) and t-test and chi-square test. P<0.05 was considered statistically significant.
Results: The mean fasting blood sugar during the study (P=0.045) and HA1C level before delivery (P=0.034) were significantly lower in the intervention group than the control group. In the control group, the number of instrumental deliveries (P=0.045) and cesarean section (P=0.041) was significantly higher than the intervention group. Also, infant hypoglycemia (P=0.033) and high infant weight (P=0.044) were significantly higher in the control group than the intervention group.
Conclusion: Telemedicine was able to control blood sugar, reduce HA1C before delivery, reduce the number of non-physiological births, reduce hypoglycemia and reduce high birth weight in women with gestational diabetes during the covid-19 pandemic.



    1. Rasekhjahromi A, Ahmadi F, Alborzi M, Kalani N. Association of Vitamin D3 and Laboratory Factors with Early Menopause: A Case-Control Study. Journal of Medicinal and Chemical Sciences 2022; 5(6):980-987.
    2. Kleinwechter H, Laubner K. Coronavirus disease 2019 (COVID-19) and pregnancy: overview and report of the first German case with COVID-19 and gestational diabetes. Diabetologe 2020: 242-6.
    3. Rasekhjahromi A, Paymard Z, Kalani N. The relationship between serum vitamin D levels and gestational diabetes: A case-control study. Iran J Obstet Gynecol Infertil 2022; 25(8):33-41.
    4. Kleinwechter H. Diabetes and pregnancy—update 2020. Der Diabetologe 2020; 16:470-7.
    5. Mimouni F, Lakshminrusimha S, Pearlman SA, Raju T, Gallagher PG, Mendlovic J. Perinatal aspects on the covid-19 pandemic: a practical resource for perinatal–neonatal specialists. Journal of Perinatology 2020; 40(5):820-6.
    6. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2020. Diabetes care 2020; 43(Supplement_1):S14-31.
    7. Chiefari E, Arcidiacono B, Foti D, Brunetti A. Gestational diabetes mellitus: an updated overview. Journal of endocrinological investigation 2017; 40:899-909.
    8. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. The Lancet 2009; 373(9677):1773-9.
    9. Kozhimannil KB, Pereira MA, Harlow BL. Association between diabetes and perinatal depression among low-income mothers. Jama 2009; 301(8):842-7.
    10. Eberle C, Ament C. Diabetic and metabolic programming: mechanisms altering the intrauterine milieu. International Scholarly Research Notices 2012; 2012.
    11. Eghdam-Zamiri R, Khanbabayi Gol M. Effects of ginger capsule on treatment of nausea and vomiting in patients receiving cisplatin undergoing mastectomy: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2020; 22(11):15-21.
    12. Eberle C, Merki E, Yamashita T, Johnson S, Armando AM, Quehenberger O, et al. (2012) Maternal Immunization Affects In Utero Programming of Insulin Resistance and Type 2 Diabetes. PLoS ONE 7(9): e45361.
    13. Yamashita T, Freigang S, Eberle C, Pattison J, Gupta S, Napoli C, et al. Maternal immunization programs postnatal immune responses and reduces atherosclerosis in offspring. Circulation research 2006; 99(7):E51-64.
    14. Khanbabayi Gol M, Eidy M, Zamani Esfahlani M. Frequency ratio of carpal tunnel syndrome in women with breast cancer treated with lymphedema in Tabriz medical education centers; 2018-2019. Iran J Obstet Gynecol Infertil 2020; 22(12):62-8.
    15. Yang H, Wang C, Poon LC. Novel coronavirus infection and pregnancy. Ultrasound Obstet Gynecol 2020; 55(4):435-437.
    16. Shahidi N, Mahdavi F, Gol MK. Comparison of emotional intelligence, body image, and quality of life between rhinoplasty candidates and control group. Journal of Education and Health Promotion 2020; 9.
    17. Ghosh A, Gupta R, Misra A. Telemedicine for diabetes care in India during COVID19 pandemic and national lockdown period: guidelines for physicians. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020; 14(4):273-6.
    18. Haghdoost SM, Gol MK. The Necessity of Paying More Attention to the Neurological and Psychological Problems Caused by COVID-19 Pandemic During Pregnancy. International Journal of Women's Health and Reproduction Sciences 2020; 8(3):243-244.
    19. Dodesini AR, Galliani S, Ciriello E, Bellante R, Trevisan R. Pre‐gestational diabetes during the COVID‐19 pandemic in Bergamo, Italy. International Journal of Gynecology & Obstetrics 2020; 151(2):295-6.
    20. Nouhjah S, Jahanfar S, Shahbazian H. Temporary changes in clinical guidelines of gestational diabetes screening and management during COVID-19 outbreak: A narrative review. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2020; 14(5):939-42.
    21. Hashemzadeh K, Dehdilani M, Gol MK. The Effect of Interval Training on Oxidative Stress Indices Among Women in Preterm Labor Underwent Coronary Artery Bypass Graft. INTERNATIONAL Journal of Women’s Health and Reproduction Sciences 2020; 8(4):406-11.
    22. Eberle C, Stichling S. Clinical improvements by telemedicine interventions managing type 1 and type 2 diabetes: systematic meta-review. Journal of medical Internet research 2021; 23(2):e23244.
    23. Eberle C, Stichling S. Effect of telemetric interventions on glycated hemoglobin A1c and management of type 2 diabetes mellitus: systematic meta-review. Journal of medical Internet research 2021; 23(2):e23252.
    24. Thomas BH, Ciliska D, Dobbins M, Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews on Evidence‐Based Nursing 2004; 1(3):176-84.
    25. Hashemzadeh K, Dehdilani M, Gol MK. Study of the effects of simple exercise with or without physiotherapy on prevention of deep vein thrombosis among postmenopausal women requiring coronary artery bypass graft surgery. Int J Womens Health Reprod Sci 2021; 9(1):69-74.
    26. Cooke WR, Billett A, Gleeson S, Jacques A, Place K, Siddall J, et al. SARS-CoV-2 infection in very preterm pregnancy: experiences from two cases. European Journal of Obstetrics & Gynecology and Reproductive Biology 2020; 250.
    27. Abedini N, Parish M, Farzin H, Pourfathi H, Akhsham M. The determination of an appropriate time for placement of the classic laryngeal mask airway in patients undergoing general anesthesia. Anesthesiology and pain medicine 2018; 8(2).
    28. Govind A, Essien S, Karthikeyan A, Fakokunde A, Janga D, Yoong W, et al. Re: novel coronavirus COVID-19 in late pregnancy: outcomes of first nine cases in an inner city London hospital. European Journal of Obstetrics and Gynecology and Reproductive Biology 2020; 251:272-4.
    29. Atashkhoei S, Abedini N, Pourfathi H, Znoz AB, Marandi PH. Baricity of bupivacaine on maternal hemodynamics after spinal anesthesia for cesarean section: a randomized controlled trial. Iranian journal of medical sciences 2017; 42(2):136.
    30. Smati S, Mahot P, Bourdiol A, Ploteau S, Hadjadj S, Cariou B. Euglycaemic ketoacidosis during gestational diabetes with concomitant COVID-19 infection. Diabetes & Metabolism 2021; 47(2):101181.
    31. Uzel K, Lakhno IV. A mortal case of coronavirus disease in a pregnant diabetic woman. Clinical case. Reproductive Endocrinology 2020; 52:33-6.
    32. Mohaddes G, Abdolalizadeh J, Babri S, Abedini N, Hossienzadeh F. The anti-edematous effect of ghrelin in brain hypoxia is associated with decreasing expression of vascular endothelial growth factor. Journal of Molecular Neuroscience 2015; 56:273-7.
    33. Charsouei S, Esfahlani MZ, Dorosti A, Zamiri RE. Effects of COVID-19 pandemic on perceived stress, quality of life, and coping strategies of women with breast cancer with spinal metastasis under chemotherapy. Int J Women's Health Reprod Sci 2021: 55-60.
    34. Fontanella F, Hannes S, Keating N, Martyn F, Browne I, Briet J, et al. COVID-19 infection during the third trimester of pregnancy: current clinical dilemmas. European Journal of Obstetrics and Gynecology and Reproductive Biology 2020; 251:268-71.
    35. Majachani N, Francois JL, Fernando AK, Zuberi J. A case of a newborn baby girl infected with SARS-CoV-2 due to transplacental viral transmission. The American Journal of Case Reports 2020; 21:e925766-1.
    36. Mobed A, Shirafkan M, Charsouei S, Sadeghzadeh J, Ahmadalipour A. Biosensors technology for anti-epileptic drugs. Clinica Chimica Acta 2022; 533:175-82.