Could better sleep prevent gestational diabetes?

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A new study links short sleep during pregnancy and gestational diabetes mellitus—suggesting that addressing sleep concerns during pregnancy could potentially reduce the risk of developing GDM.

GDM, which is diagnosed by high blood glucose levels, is one of the most common health problems during pregnancy. Unmanaged high glucose levels in pregnancy can result in complications that can affect both mother and child including pre-term labor, obstructed labor, birth trauma, high blood pressure for mothers, and increased risk of mother and fetal deaths.

Sleep has been identified as one of the factors that affects glucose metabolism, and some studies have indicated that short sleep is a risk factor for type 2 diabetes. However, few studies have examined the relationship between sleep and GDM, especially in a multi-ethnic (Chinese, Malay, and Indian) Asian population.

Recent work suggests adults in Singapore are among the most sleep-deprived in the world. This lack of sleep could contribute to GDM in Asian women, who are already at increased risk of GDM compared with Caucasian women.

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In order to determine if short sleep duration is associated with increased risk of GDM, Joshua Gooley, associate professor at Duke-NUS Medical School and Cai Shirong from NUS Yong Loo Lin School of Medicine and a member of the National University Health System (NUHS), analyzed the sleep and glucose levels of participants in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.

To examine the potential link between short sleep and GDM, 686 women completed a sleep questionnaire and had their glucose levels measured in a standard clinical test (oral glucose tolerance test) at 26 to 28 weeks of gestation. Of the 686 participants who had their glucose levels measured, 131 (19 percent) received the GDM diagnosis.

The results of statistical analyses suggest that short sleep was associated with increased risk of GDM, after adjusting for factors including age, BMI, and history of GDM. The frequency of GDM was highest (27.3 percent) in women who reported sleeping less than six hours a night and was lowest (16.8 percent) in women who reported sleeping between seven to eight hours a night.

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Results are consistent with findings that show that short sleep is associated with type 2 diabetes in non-pregnant populations. They are also consistent with smaller studies with Caucasian and African-American pregnant women.

“Our results raise the possibility that good sleep habits could reduce the likelihood of developing hyperglycemia and GDM,” says Gooley, senior author of the paper in SLEEP and member of the neuroscience and behavioral disorders program at Duke-NUS.

“Our study provides a better understanding of how we may be able to counter a potentially serious condition for pregnant women and her child,” adds Cai, who is first author of the paper. “Additional studies are needed to assess the contribution of other modifiable lifestyle factors to GDM risk.”

The study is a collaboration between KK Women’s and Children’s Hospital, the NUHS and the Singapore Institute for Clinical Sciences (SICS), the Agency for Science, Technology and Research (A*STAR).

Support for the research came from Singapore’s National Research Foundation, SICS, A*STAR, and Duke-NUS’ Signature Research Programme via the Singapore Ministry of Health and A*STAR.

Source: Duke-NUS