Obstructive sleep apnea and diet-controlled gestational diabetes

Area of Science:

• Obstetrics and Gynecology
• Endocrinology
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) is linked to gestational diabetes mellitus (GDM).
• Prevalence, metabolic impact, and predictors of OSA in GDM require further study.
• Obesity is a common comorbidity in GDM.

Purpose of the Study:

• To determine the prevalence of OSA in obese pregnant women with diet-controlled GDM.
• To investigate the relationship between OSA severity and metabolic control (glucose, insulin resistance, beta-cell function).
• To develop a predictive screening tool for OSA in this population.

Main Methods:

• Eighty-two obese pregnant women with diet-controlled GDM (24-34 weeks gestation) were enrolled.
• OSA symptoms assessed via Berlin Questionnaire; diagnosis confirmed by overnight monitoring.
• Metabolic parameters evaluated using fasting glucose, HbA1c, and a meal tolerance test (MTT) for OSA patients.

Main Results:

• OSA diagnosed in 52.4% of participants at a median gestational age of 29 weeks.
• More severe OSA correlated with higher fasting glucose, insulin resistance, and beta-cell dysfunction.
• A screening tool using neck circumference and Berlin Questionnaire score showed 70% overall accuracy.

Conclusions:

• OSA is highly prevalent in obese, diet-controlled GDM pregnancies.
• OSA severity, particularly oxygen desaturation, impacts glucose metabolism and insulin sensitivity.
• A simple screening tool combining neck circumference and the Berlin Questionnaire can identify GDM patients at risk for OSA.