A Hybrid Telehealth Model Offers Access to Specialty Diabetes Care in Pregnancy

Authors

• Katherine M. Davis, Department of Obstetrics and Gynecology, Atrium Health Wake Forest Baptist and Wake Forest University School of Medicine, Winston-Salem, North CarolinaFollow
• Wendy Craig, MaineHealth Institute for Research, Scarborough, Maine
• Kelley Conroy, Department of Obstetrics and Gynecology, MaineHealth Maine Medical Center, Portland, Maine

Submission Type

Original Research

Abstract

Introduction: Diabetes in pregnancy is increasing in the United States and is associated with greater maternal and neonatal morbidity. Continuous glucose monitors (CGMs) improve glycemic control, but data on outcomes with telehealth-based diabetes management in pregnancy remain limited. This study compared glycemic control and perinatal outcomes among pregnant people with diabetes managed using CGMs through in-person care versus a hybrid-option model.
Methods: We conducted a retrospective cohort study of patients with singleton pregnancies and diabetes managed with CGMs from January 2018 to June 2022. Participants receiving third-trimester care before the COVID-19 pandemic comprised the traditional group, whereas those managed during the pandemic comprised the hybrid-option group, incorporating telehealth and/or in-person visits. The primary outcome was the percentage of time within target glucose range during the third trimester. Secondary outcomes included maternal and neonatal outcomes.
Results: Ninety-one participants met inclusion criteria, and maternal demographics and diabetes characteristics were similar between groups. Mean (CI) time in range did not differ significantly (83.2[80.1–86.3] vs 81.3 [77.8–85.0]; P = .48), with both groups exceeding recommended targets. Maternal and neonatal outcomes, including macrosomia and neonatal intensive care unit admission, appear similar based on these exploratory findings.
Discussion: Strengths included use of CGM-derived metrics; however, interpretation is limited by the small sample size, single-system design, and changes in glucose targets and care patterns. Findings align with prior telehealth literature and extend evidence to include glycemic outcomes in pregnancy.
Conclusions: A hybrid-option model for CGM-based diabetes management in pregnancy may provide glycemic control similar to traditional in-person care.

Recommended Citation

Davis, Katherine M.; Craig, Wendy; and Conroy, Kelley (2026) "A Hybrid Telehealth Model Offers Access to Specialty Diabetes Care in Pregnancy," Journal of Maine Medical Center: Vol. 8 : Iss. 2 , Article 9.
Available at: https://doi.org/10.46804/2641-2225.1267