Summary of findings 2. Telemedicine versus standard care for glucose monitoring in gestational diabetes during pregnancy (effect on child).
| Telemedicine versus standard care for glucose monitoring in gestational diabetes during pregnancy (effect on child) | ||||||
| Patient or population: women with gestational diabetes mellitus Setting: 2 RCTs in USA; 1 RCT each in Italy, Ireland, and Spain set in clinics or hospitals Intervention: telemedicine Comparison: standard care | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Risk with standard care | Risk with telemedicine | |||||
| Perinatal mortality (including stillbirth or neonatal death) | Study population | ‐ | 131 (2 RCTs) | ⊕⊝⊝⊝ VERY LOW1,2 | There were no perinatal deaths in 2 RCTs | |
| See comment | See comment | |||||
| Large‐for‐gestational age | Study population | RR 1.41 (0.76 to 2.64) | 228 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW3,4 | ||
| 126 per 1000 | 178 per 1000 (96 to 333) | |||||
| Death or serious morbidity composite | Study population | RR 1.06 (0.68 to 1.66) | 57 (1 RCT) | ⊕⊝⊝⊝ VERY LOW4,5 | ||
| 560 per 1000 | 594 per 1000 (381 to 930) | |||||
| Neurosensory disability | Study population | Not estimable | (0 RCTS) | ‐ | None of the included RCTs reported this outcome | |
| 0 per 100 | 0 per 1000 (0 to 0) |
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| Hypoglycaemia | Study population | RR 1.14 (0.48 to 2.72) | 198 (3 RCTs) | ⊕⊝⊝⊝ VERY LOW4,6 | ||
| 82 per 100 | 94 per 1000 (40 to 224) | |||||
| Adiposity (e.g. BMI, skinfold thickness, fat mass) | Study population | Not estimable | (0 RCTs) | ‐ | None of the included RCTs reported this outcome | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| Type 2 diabetes | Study population | Not estimable | (0 RCTs) | ‐ | None of the included RCTs reported this outcome | |
| 0 per 1000 | 0 per 1000 (0 to 0) | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). BMI: body mass index;CI: confidence interval; RCT: randomised controlled trial; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | ||||||
1Study limitations (downgraded 1 level): 2 RCTs with potentially serious design limitations 2Imprecision (downgraded 2 levels): no events and small sample size(s) 3Study limitations (downgraded 2 levels): 2 RCTs with potentially serious design limitations, and 1 RCT with serious or very serious design limitations (> 25% of weight) 4Imprecision (downgraded 2 levels): wide confidence interval crossing the line of no effect, (few events), small sample size(s) 5Study limitations (downgraded 1 level): 1 RCT with potentially serious design limitations 6Study limitations (downgraded 1 level): 2 RCTs with potentially serious design limitations, and 1 RCT with serious or very serious design limitations (< 7% of weight)