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Chronobiological Factors Influencing Glycemic Control and Birth Outcomes in Gestational Diabetes Mellitus
Amalia Messika1,2,3, Yoel Toledano1,2, Eran Hadar1,2
1Helen Schneider Hospital for Women, Rabin Medical Center, Petach Tikva 4941492, Israel.
Background/Objectives:
Studies have shown that chronobiological factors may adversely affect glycemic control in patients with type 2 diabetes mellitus. We assessed the association of chronobiological factors with glycemic control and neonatal birth weight in women with GDM.
Methods:
A prospective cohort study included 208 women aged 18-45 years with a singleton pregnancy who were randomly selected from among women undergoing follow-up for GDM at the Maternal-Fetal Medicine Unit of a tertiary medical center. Nutrition, sleep, and lifestyle patterns were assessed from onset of GDM until birth along with glycemic control and birth outcomes.
Results:
Multivariate analyses on a cohort of 208 women revealed that suboptimal glycemic control was associated with a late breakfast (RR = 2.26; 95% CI 1.09-4.67), increased carbohydrate intake in the evening (RR = 1.19; 95% CI 1.003-1.42), and poor sleep quality (RR = 2.14; 95% CI 1.04-4.41). The adjusted relative risk for neonatal birth weight above the 85th percentile was associated with increased carbohydrate intake in the morning (RR = 1.70; 95% CI 1.30-2.23) and increased carbohydrate intake in the evening (RR = 1.39; 95% CI 1.16-1.67).
Conclusions:
Chronobiological factors are associated with suboptimal glycemic control and birth weight above the 85th percentile in women with GDM. The study was registered under ClinicalTrials.gov.org, identifier: NCT02916667.
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