Avera Program Succeeds in Fight Against Gestational Diabetes
Avera women’s health professionals knew the problem they faced – gestational diabetes – was tough to treat in rural settings. But a federal grant and a dedicated, patient-centered approach helped “the little program that could” succeed for moms and babies.
“We met with moms-to-be in bathrooms, break rooms and teachers’ lounges,” said Kimberlee McKay, MD, with Avera Medical Group Obstetrics and Gynecology. “We made it convenient for every patient, and we were able to coach, chart and coax them, even if they were hours away from us.”
Avera teams included registered dietitians and certified diabetes educators who used Avera’s virtual visit platform to conduct their interactions with moms in South Dakota.
The program began in 2016, and now can show its results, which include:
A decrease in vaginal delivery complications of almost 27%
A decrease in cesarean delivery complications of 17.6%
A reduction in the number of infants born at weights of 4000 grams or more
“Our hypothesis was whether or not this sort of coaching and counsel would work – and it does,” McKay said. “The challenge remaining is that it takes reimbursement so long. The tools can help every patient.”
But making them available to every patient takes funding. “The Health Resources & Services Administration grant got this program started,” McKay added.
The program now serves patients in Minnesota and soon will reach those in Iowa and Nebraska. It aims to support pregnant patients where they are.
The Threat Worth Facing and Stopping
Gestational diabetes is often symptomless and if unnoticed, can lead to high blood pressure, preeclampsia and other serious complications. It also doubles the chance the newborn will contract type 2 diabetes later in life.
“We developed a specialized blood sugar monitor to track numbers,” McKay said. “We also had to do a lot of talking and teaching. That can be daunting via telehealth.”
Since it began, the program has served more than 450 patients. They quickly realized the necessity for outreach. “When we get an abnormal level, we can contact them right away,” McKay said. “Now with timely meds or coaching, we can get on a problem before it addressed.”
Creative Coach for Patients in “Food Deserts”
The Avera teams knew the limits of the locations where their patients lived. Advising them to “eat more fresh food” wasn’t always easy.
“Healthy eating is complicated, especially in a rural area,” McKay said. “We could coach them on best choices even at a convenience store or a fast-food restaurant.”
Making these conversations simpler is one of the reasons the program works.
“We’re saving a lot of moms the burdens that might come with an appointment, hours of travel and other issues,” she said. “When we can provide an ‘easy’ button, we can help make sure better outcomes take place.”