Last week, I had the opportunity to attend and speak at the 17th Biennial Meeting of the Diabetes in Pregnancy Study Group Conference. It was an incredible opportunity to learn about recent research developments and new research studies focused on diabetes in pregnancy – a topic near and dear to Delfina – from experts who play an active role in caring for pregnant patients with diabetes.
Here are a few highlights from the conference that strongly resonated with me and our mission at Delfina:
Diabetes in pregnancy has a transgenerational effect, such that the children of mothers with diabetes are at an increased risk of obesity, insulin resistance, and diabetes. Shelley Ehrlich, MD, ScD, MPH presented preliminary results from the TEAM Study demonstrating that exposure to dysglycemia in utero increased the risk of morbid obesity in adulthood. This is an incredibly unique study design – the study team recruited children (now adults) of women with pregestational diabetes who were involved in a prior study (Diabetes in Pregnancy Program Project Grant) that ran from 1978-1993. We are excited to incorporate the findings from the TEAM Study into Delfina Care to better care for individuals with pregestational diabetes before, during, and after their pregnancy!
Preconception care for mothers with pregestational diabetes prevents adverse neonatal outcomes. Chloe Zera, MD, MPH presented data on how substantial health and cost burden could be prevented by universal preconception care among individuals with pregestational diabetes. However, there are significant barriers to patients receiving preconception care including, having a known diagnosis of diabetes (1.3% of reproductive age women have undiagnosed diabetes) and ability to access preconception care. We are eager to address these barriers to care with our provider teams and health plan partners to ensure that all patients can access quality preconception care.
Continuous glucose monitoring (CGM) improves neonatal outcomes among mothers with Type 1 diabetes. Celeste Durnwald, MDpresented findings from the CONCEPTT trial demonstrating that the use of CGM (vs. fingerstick) to monitor blood sugar levels during pregnancy resulted in lower rates of infants who were: large for gestational age, diagnosed with neonatal hypoglycemia, or admitted to the neonatal intensive care unit. Our Data Science team is actively developing modeling methods for analyzing CGM time series data to better understand glucose profiles and the association with adverse pregnancy outcomes.