Gestational diabetes & diabetes in pregnancy
The metabolic and circadian signatures of gestational diabetes in the postpartum period characterised using multiple wearable devices
Authors' conclusion
We reveal GDM-related postpartum differences in glucose variability and 24 h rhythms, even among women clinically considered to be normoglycaemic. Our results provide a rationale for future interventions aimed at improving glucose variability and encouraging earlier daily behavioural patterns to mitigate the long-term cardiometabolic risk of GDM.
Study context
- Population
- Postpartum women assessed at 1–2 months after delivery (baseline) and 6 months later (follow-up), free-living conditions, 2 week monitoring with CGM, smartphone food diary, accelerometers and heart rate monitors
- Participants
- 22 vs 15
- Exposure
- Women with prior gestational diabetes mellitus (GDM) vs women with normal glucose metabolism in pregnancy, postpartum
- GDMn = 22
- non-GDMn = 15reference
- Outcome
- Clinical and CGM-derived glycaemic variables, GDM vs non-GDM
- Follow-up
- Baseline
Main finding
As reported in the abstract
baseline
- Higher BMI, HbA1c and mean amplitude of glycaemic excursion with GDM (all p≤0.05)
- Slower postprandial glucose decrease with GDM (p=0.01), despite lower proportion of carbohydrate intake
- Similar mean glucose levels
- Reduced amplitude of underlying glucose 24 h rhythm with GDM (p=0.005)
- Differences in CGM-derived variables persisted when the five women with prediabetes were removed
Observational data: associations, not effects.
Further findings
Longitudinal change, baseline to follow-up · baseline to 6 months later
- Significant increase in fasting plasma glucose across both groups
- CGM-derived metrics showed no differences from baseline to follow-up
Circadian timing and glycaemia (linear mixed model)
- Late circadian timing (sleep midpoint, eating midpoint, peak time of heart rate) correlated with higher fasting plasma glucose and reduced amplitude of glucose 24 h rhythm (all p≤0.05)
Original publication
The metabolic and circadian signatures of gestational diabetes in the postpartum period characterised using multiple wearable devices. Diabetologia. Published 12 November 2024. doi:10.
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