Chronobiological disorders and their impact on gestational diabetes
mellitus outcomes: the Chrono-Nutrition Gestational Diabetes Study
Abstract
Objective Studies have shown that chronobiological factors may adversely
affect glycemic control in patients with type 2 diabetes mellitus
(T2DM). Our objective was to assess the association of chronobiological
disorders with glycemic control and neonatal birthweight in women with
GDM. Design A prospective observational study was conducted. Setting
Israel Population 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 in 2016
and 2017. Methods Nutrition, sleep, and lifestyle patterns were assessed
from onset of GDM until birth along with glycemic control and
obstetrical outcomes. Data were collected by structured interview and
from the medical files. Main outcome measures Maternal glycemic control
and large for gestational age (LGA) neonate. Results Multivariate
analyses on a cohort of 208 women revealed suboptimal glycemic control
which was associated with a late breakfast (RR=2.26; 95% CI 1.09-4.67).
Any 10-g increase in carbohydrate intake in the evening increased the
risk 1.19 times for suboptimal glycemic control (RR=1.19; 95% CI
1.003-1.42), and 2.14 times for poor sleep quality (RR=2.14; 95% CI
1.04-4.41). The adjusted relative risk for birthweight above the 85th
percentile was associated with excessive of 10-g increase of
carbohydrate intake in the morning (RR=1.70; 95%CI 1.30-2.23) and in
the evening (RR=1.39; 95% CI 1.16-1.67). Conclusions Chronobiological
disorders are associated with suboptimal glycemic control and
large-for-gestational-age newborn in women with GDM.