Poor sleep quality is associated with impaired glucose tolerance in women after gestational diabetes.
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 (δ = 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.
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Ferrari
Department of Psychosomatic Medicine, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany. Electronic address: heike.kuenzel@med.uni-muenchen.de.
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Künzel
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Tröndle
Institute of Medical Information Sciences, Biometry, and Epidemiology, LMU, Munich, Germany.
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Rottenkolber
Institute of Medical Information Sciences, Biometry, and Epidemiology, LMU, Munich, Germany.
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Kohn
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Fugmann
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Banning
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Weise
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Sacco
Department of Gynecology and Obstetrics, Klinikum der Universität München, Munich, Germany.
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Hasbargen
Department of Gynecology and Obstetrics, Klinikum der Universität München, Munich, Germany.
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Hutter
Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany; Medizinische Klinik und Poliklinik 2, Klinikum der Universität München, Munich, Germany.
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Parhofer
RG Molecular Psychology, Max Planck Institute of Psychiatry, Munich, Germany.
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Kloiber
RG Psychiatric Pharmacogenetics, Max Planck Institute of Psychiatry, Munich, Germany.
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Ising
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Seissler
Diabetes Research Group, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstr. 1, 80336 München, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Research Center for Environmental Health, Germany; Deutsches Zentrum für Diabetesforschung (DZD), Germany.
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Lechner
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D048909:Diabetes Complications / Q000150:complications*; D016640:Diabetes, Gestational / Q000503:physiopathology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires
D001786:Blood Glucose
Gestational diabetes; Glucose tolerance; Perceived stress; Sleep quality