Home-Ultrasound in Routine High-Risk Care of Patients With Gestational Diabetes Mellitus (GDM)

Assessed using the Diabetes Treatment Satisfaction Questionnaire (DTSQ). It is composed of eight questions, each of which is scored by patients on a scale ranging from zero ("very dissatisfied", "very inconvenient") to six (e.g., "very satisfied", "very convenient").

The questionnaire is composed of two different factors- the first 6 questions assess treatment satisfaction and the last 2 questions assess burden of hyper or hypo-glycemia. the sum of the first 6 points (maximum 36 points) score the treatment satisfaction, with a higher score indicating higher treatment satisfaction.

Difference in patient satisfaction as measured by the Diabetes Treatment Satisfaction Questionnaire (DTSQ) between early pregnancy (after first visit) and late pregnancy (37-39 weeks gestation).

It is composed of eight questions, each of which is scored by patients on a scale ranging from zero ("very dissatisfied", "very inconvenient") to six (e.g., "very satisfied", "very convenient").

The questionnaire is composed of two different factors- the first 6 questions assess treatment satisfaction and the last 2 questions assess burden of hyper or hypo-glycemia. the sum of the first 6 points (maximum 36 points) score the treatment satisfaction, with a higher score indicating higher treatment satisfaction.

Assessment of maternal glycemic control based on percent of abnormal glucose values during follow-up (via glucose log or continuous glucose monitoring where available), as recorded by treating physician.

Clinician satisfaction will be assessed using a structured questionnaire developed for this study. Physicians will rate various aspects of the telemedicine or in-person follow-up experience, including:

Ease of use

Clinical value

Workflow and efficiency

Communication and patient engagement

Technical issues and support

Each domain will be rated on a 10-point numeric rating scale (0-10), where:

0 = Not satisfied at all

10 = Extremely satisfied

Higher scores indicate greater satisfaction.

Evaluation of mode of delivery (vaginal, cesarean)

Birth weight

Estimated costs incurred by patients for follow-up (including travel, parking, time off work), collected via structured questionnaire.

Estimated resource and time costs for the healthcare system based on visit type (in-person vs. telemedicine), calculated per patient.

Duration of each visit, separately recorded for patient time and physician Duration of each clinical visit will be recorded in minutes for both the patient and the physician. This includes both in-person and telemedicine encounters. Separate timing will be documented for:

Patient time (including waiting and consultation)

Physician time (active interaction and documentation)

These data will be used to compare time efficiency between the two care models.

Number and reason for unscheduled emergency room visits related to pregnancy or GDM during the study period.

Gestational age at birth

The number of neonates requiring admission to the neonatal intensive care unit (NICU) following delivery will be recorded and reported. This will be used as an indicator of neonatal morbidity.