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Master Thesis

Télésurveillance du diabète gestationnel à l'hôpital de Libourne : difficultés de mise en oeuvre

Abstract : Background: prevalence of Gestational Diabetes Mellitus (GDM) is estimated between 6 and 14 % in France. The GDM management efficiency on pregnancy outcomes and the emerging Telemedicine seems to be promising. Objective: to determine feasibility, reliability, acceptability and efficiency of GDM telemonitoring system based on Internet at the Libourne hospital. Method: 61 non selective women with GDM were randomly assigned in two groups: a Telephone group (T) n = 31 and an Internet group (I) n = 30. We first determined the number, the characteristics and limiting factors of women not able to access to an Internet telemonitoring from the group I. Then we compared the two groups regarding distance contacts, medical time per contact, compliance of face-to-face consultations, compliance of care provider advices and women satisfaction. Finally, we observed the number of women with insulin-treated GDM, the time between diagnosis and insulin requirement and pregnancy outcomes in each group. Results: 12/30 women couldn’t be followed initially with Internet. 83 % were unemployed. They were more likely to have GDM risk factors (2.7 vs 1.6, p = 0.010). Limiting factors were Internet access (6/12), computer skills (6/12) and their own choice (4/12). After all, Internet monitoring allowed more distance contacts (1 vs 0.6/week, p = 0.041), was less time-consuming (194 s vs 403 s, p = 0.0006) without any compliance change. All women were satisfied but a greater feeling of exchange efficiency was perceived in the group T. Despite our small sample size, Internet monitoring was neither associated with an initiating delay of insulin nor with more pregnancy adverse outcomes. Conclusions: Although our GDM telemonitoring system based on Internet at the Libourne hospital was reliable, associated to a high acceptance and safe, it wasn’t appropriate to our population with low socio-economic level.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01223432
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Submitted on : Monday, November 2, 2015 - 4:04:55 PM
Last modification on : Wednesday, July 25, 2018 - 1:22:17 AM
Long-term archiving on: : Wednesday, February 3, 2016 - 10:55:41 AM

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Lisa Teyssandier Parret. Télésurveillance du diabète gestationnel à l'hôpital de Libourne : difficultés de mise en oeuvre. Médecine humaine et pathologie. 2015. ⟨dumas-01223432⟩

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