Impact of clinical pharmacist intervention on blood glucose control and perinatal outcomes in gestational diabetes mellitus through a diabetes management system

Abstract

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) Summary 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. Key words: Clinical pharmacist; Diabetes management system; Gestational diabetes mellitus; Blood glucose control; Perinatal outcome.