Women with gestational diabetes who monitored their blood glucose remotely needed substantially fewer outpatient clinic visits than those receiving standard hospital care, according to a pre-post study published in BMC Medicine. The study, conducted at a large teaching hospital in the Netherlands, compared two independent groups of women treated for gestational diabetes mellitus: 623 patients in total were included in the analysis.
The usual care group comprised women treated between January 2020 and November 2022, who received care according to hospital guidelines. The intervention group, treated between December 2022 and February 2025, predominantly received remote monitoring, with glucose measurements transmitted via an application and reviewed by nurses at a Virtual Care Centre. Routine antenatal care was provided in parallel in both groups. In the intervention group, 81 percent of women actually received remote monitoring.
The primary outcome was the proportion of newborns who were large for gestational age, a condition associated with gestational diabetes. Large-for-gestational-age newborns accounted for 20.3 percent of births in the remote monitoring group and 17.8 percent in the usual care group, an estimated difference of 2.5 percentage points with a 95 percent confidence interval of -3.9 to 9.0 percent.
Those figures carry an important caveat. The researchers had pre-specified a non-inferiority margin of 8 percentage points for large-for-gestational-age births, meaning remote monitoring would be considered clinically acceptable if its results were no worse than usual care by more than that margin. The upper bound of the confidence interval, 9 percent, exceeded that margin, so the authors concluded the results are inconclusive: the sample size was insufficient to establish non-inferiority, even though no statistically significant difference between the groups was observed.
Beyond the primary outcome, the study found no significant differences in complication rates between the two groups. Caesarean section rates and pregnancy-related maternal and neonatal complications were unaffected by the switch to remote monitoring, according to the authors’ conclusions.
The clearest difference appeared in hospital service use. The mean number of outpatient clinic visits per patient during pregnancy for the internal medicine department was 1.6 in the remote monitoring group, compared with 2.8 in the usual care group, a difference the authors reported as statistically significant. This reduction in in-person visits is central to the study’s motivation, as the authors note that digital care is increasingly used to alleviate capacity use in hospital care.
The study also examined how the remote monitoring system functioned in practice. Adherence to glucose measurements was described as good. Most patients did not require interventions from Virtual Care Centre nurses, and most messages sent to patients were automatically generated rather than individually composed, suggesting the system operated largely through automated feedback.
The authors caution that further research on subjective experiences and clinical outcomes of gestational diabetes may contribute to optimizing remote monitoring and reducing capacity use. The study was published as an open-access article on 29 October 2026 and is being shared early to provide faster access to peer-reviewed, accepted research; this version is subject to further edits before the final Version of Record.
As a pre-post study comparing two independent groups treated in different time periods rather than a randomized trial, the design cannot rule out the influence of changes over time other than the introduction of remote monitoring. The authors also note that the sample sizes were insufficient to establish non-inferiority for the primary outcome. Nevertheless, the findings suggest that remote glucose monitoring for gestational diabetes, delivered by specialized nurses reviewing app-transmitted measurements, can reduce hospital workload without detectable harm to pregnancy outcomes, while definitive conclusions about large-for-gestational-age births await larger studies.
Subject of Research: Remote monitoring versus usual care for gestational diabetes and its effects on maternal and neonatal outcomes
Article Title: Remote monitoring for gestational diabetes: neonatal and maternal outcomes compared to usual care
Article References: Jansen, A.-J., Kooij, L., Wijnberger, L., van Bon, A., van Harten, W., & Doggen, C. (2026). Remote monitoring for gestational diabetes: neonatal and maternal outcomes compared to usual care. BMC Medicine. https://doi.org/10.1186/s12916-026-05350-5
Image Credits: AI Generated
DOI: 10.1186/s12916-026-05350-5
Keywords: gestational diabetes, remote monitoring, telemedicine, neonatal outcomes, caesarean section, large for gestational age, hospital service use, pre-post study, non-inferiority, maternal health, BMC Medicine, Netherlands
News Source: Harold Sullivan. (October 29, 2026). Remote Monitoring for Gestational Diabetes Shows Fewer Hospital Visits but Inconclusive Neonatal Results. Scienmag.
