As the most accessible health care providers, pharmacists are in a unique position to counsel patients with gestational diabetes about the importance of taking their medications and lifestyle interventions.
In a poster presentation at the 2019 Annual American Society of Health-System Pharmacists Midyear Clinical Meeting & Exposition, Taylor McGhee, who is a PharmD candidate at High Point University Fred Wilson School of Pharmacy, and her colleagues noted that “a prospective pharmacist intervention to be made in these patients is proper initiation therapy with oral diabetes agent or injectable insulin as well as strict insulin control and titration during weeks 26 to 36.”
In an interview with Drug Topics at the meeting, McGhee said that although the study was in a health system setting, retail pharmacists have a role to play in counseling patients with gestational diabetes as well.
The study researchers included 30 patients with gestational diabetes who had a mean hemoglobin A1c of 5.28 and a mean body mass index (BMI) of 32.05.
Although the patients’ treatments were managed by nurse and nurse practitioners, McGhee said their findings, which noted three patients who were given a rapid acting insulin either didn’t pick them up or didn’t use them, clearly demonstrated where a pharmacist’s intervention could have helped.
McGhee said that in this sample, no pharmacists were involved in patient management, but had they been involved, it’s possible that the patients’ adherence to their recommended regimens would have been better. Since the researchers also noted that since about 67% of the patients with high AC ratios had babies with hypoglycemia less than 45 mg/dl at birth, the potential clinical implications of a pharmacy-led intervention become even more clear, she explained.
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In their poster, the researchers noted that “medication adjustments by a clinical pharmacist can be made based on A1c percentages and self-reported blood glucose readings. Having clinical pharmacists available to gestational diabetes patients within ambulatory care settings could help lead to improved gestational diabetes care and better outcomes for both mother and baby.”
In the retail setting, McGhee noted that pharmacists can be another important health care provider for patients. Discussing the importance of adherence to recommended diabetes treatments, counseling about interventions and “just being another person to talk to about all this,” are key, she said.