Telemedicine Monitoring of Gestational Diabetes Mellitus: A 5-Year Observational Study on 4,623 Patients and Its Impact on Hospital Resource Utilization

Abstract

Background: Gestational diabetes mellitus (GDM) requires continuous metabolic monitoring to prevent obstetric and neonatal complications. This traditionally involves a high volume of in-person outpatient visits.
Objective: To evaluate the clinical and organizational impact of a large-scale, structured telemedicine model implemented over a 5-year period at Mestre Hospital.
Methods: A retrospective observational study was conducted on a cohort of 4,623 consecutive patients diagnosed with GDM. The digital protocol integrated LibreView, LifeScan OneTouch Reveal®, and Contour Next platforms for asynchronous remote transmission of glycemic profiles alongside specialist teleconsultations. Crucially, all utilized platforms were fully compliant with data privacy frameworks, ensuring complete data anonymity. Physical appointments were restricted to initial assessments or non-deferrable clinical instability.
Results: The implementation of the digital care pathway induced a 92.0% reduction in physical outpatient visits compared to historical standard care. On the clinical front, 98.4% of patients achieved optimal metabolic targets. Following the diagnosis of GDM, the spontaneous abortion (miscarriage) rate was
1.34% (n = 62). Subsequent major complication rates among progressing pregnancies were remarkably low, with an incidence of fetal macrosomia at 1.9%, a cesarean delivery rate of 27.0%, and neonatal intensive care unit (NICU) admissions at 1.0%.
Conclusions: Large-scale telemedicine for GDM is a highly efficient, safe, and sustainable strategy. It guarantees excellent metabolic control and obstetricneonatal outcomes in line with international standards, while drastically mitigating pressure on hospital infrastructures through anonymized and secure data ecosystems.