The Impact of Proactive and Personalized Strategies in the Self-Monitoring of Blood Glucose in Women with Diabetes in Pregnancy: The Experience of the Cohort Cuido Mi Embarazo in Mexico

Women with Diabetes in Pregnancy (DP) have a higher risk of maternal-fetal complications, unfortunately in Mexico, its detection is only carried out in 1% of cases, and glucometers and glucose strips are not available for self-monitoring of blood glucose (SMBG). The cohort Cuido mi Embarazo (CME) ensures supplies for the Oral Glucose Tolerance Test (OGTT) and glucose screening through MIDO Embarazo®. Educational strategies have been implemented for health personnel focused on prevention, diagnosis and management. Patients with DP have been offered medical and nutritional counseling, and digital glucometers and glucose strips for SMBG. Up to now, 854 women are actively monitored and have performed the OGTT. 117 women have been found with diabetes, of which 96 (82.05%) are Gestational Diabetes (GDM) and 21 (17.95%) are pre-gestational diabetes, finding a prevalence of GDM of 11.2%. Regarding the SMBG in 84 women with diabetes that completed their pregnancy, 62 (73.8%) completed glucose measurements, representing a higher figure than the international literature. From those patients that completed their pregnancy with complete SMBG according to international standards, 39 (62.9%) women achieved control, 23 (37.1%) did not achieve control. No cases of children with macrosomia were detected. In the framework of the CME Cohort, it is demonstrated that: 1) Performing the OGTT and capillary glucose screening through MIDO Embarazo® allow the timely detection of DP. 2) Providing digital glucometers and glucose strips for SMBG, guarantees measurement, increases adherence and glucose control, and improves the health of the newborn and the mother. 3) The systematic approach that also includes the proactive participation of health professionals in the health center is a key element for success for the timely and adequate diagnosis of DP. These conclusions represent a significant public health lesson in Mexico.