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Abstract:
We analyzed the association of sleep quality and glucose metabolism in
women after gestational diabetes (pGDM) and in women after normoglycemic
pregnancy (controls). Data during pregnancy and a visit within the first
15 months after delivery were collected from 61 pGDM and 30 controls in
a prospective cohort study. This included a medical history, physical
examination, questionnaires (Pittsburgh Sleep Quality Index (PSQI), and
Perceived Stress Scale (PSS)), and 5-point oral glucose tolerance test
with insulin measurements to determine indices of insulin sensitivity
and insulin secretion. We used Spearman correlation coefficients and
multivariate regression models for analysis 9.3 +/- 3.2 months after
delivery, pGDM had significantly higher fasting and 2 h glucose levels
and lower insulin sensitivity than controls. There was no significant
difference in age, BMI and sleep quality as assessed with the PSQI
between the two groups. The PSQI score correlated with the ogtt-2 h
plasma glucose in pGDM (delta = 0.41; p = 0.0012), but not in controls.
This association was confirmed with a multivariate linear regression
model with adjustment for age, BMI and months post-delivery. Perceived
stress was an independent risk factor (OR 1.12; 95% CI 1.02-1.23) for
impaired sleep. Our findings suggest that post-delivery sleep quality
significantly influences glucose tolerance in women after GDM and that
impaired sleep is associated with increased stress perception. Measures
to improve of sleep quality and reduce perceived stress should therefore
be tested as additional strategies to prevent progression to type 2
diabetes after GDM. (C) 2015 Elsevier Ltd. All rights reserved.
