Response to Comment on Law et al. Suboptimal Nocturnal Glucose Control Is Associated With Large for Gestational Age in Treated Gestational Diabetes Mellitus. Diabetes Care 2019;42:810–815

Law, Graham; Alnaji, Alia; Alrefaii, Lina; Endersby, Del; Cartland, Sarah J.; Gilbey, S. G.; Jennings, Paul; Murphy, Helen; Scott, Eleanor M.

doi:10.2337/dci19-0018

Cited by 3 publications

(1 citation statement)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Law et al published a CGM-based glucose analysis of GDM pregnancies and showed that mothers of LGA infants ran significantly higher glucose overnight. Consequently, the authors recommend better detection and controlling of nocturnal glucose levels to prevent fetal overnutrition [ 25 ]. It has also been shown that even first trimester glucose is significantly and independently associated with LGA newborns [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Circadian rhythm and gestational diabetes: working conditions, sleeping habits and lifestyle influence insulin dependency during pregnancy

et al. 2021

View full text Add to dashboard Cite

Objective Management of gestational diabetes (GDM) is currently changing toward a more personalized approach. There is a growing number of GDM patients requiring only a single dose of basal insulin at night to achieve glucose control. Well-known risk factors like obesity, parity and family history have been associated with GDM treatment requirements. Sleep quality and lifestyle factors interfering with the circadian rhythm are known to affect glucose metabolism. The aim of this study was to investigate the impact of such lifestyle factors on insulin requirement in GDM patients, in particular on long-acting insulin to control fasting glucose levels. Research design and methods A total of 805 patients treated for GDM between 2012 and 2016 received a study questionnaire on lifestyle conditions. Sleep quality and work condition categories were used for subgroup analysis. Independent effects on treatment approaches were evaluated using multivariate regression. Results In total, 235 (29.2%) questionnaires returned. Women reporting poor sleep conditions had higher pre-pregnancy weight and BMI, heavier newborns, more large for gestational age newborns and higher rates of hyperbilirubinemia. Treatment requirements were related to sleep and work condition categories. Multivariate regression for ‘Basal’ insulin-only treatment revealed an adjOR 3.4 (CI 1.23–9.40, p < 0.05) for unfavorable work conditions and adjOR 4.3 (CI 1.28–14.50, p < 0.05) for living with children. Conclusions Our findings suggest that external stressors like unfavorable work conditions and living with children are independently associated with the necessity of long-acting insulin at night in GDM patients. Thus, fasting glucose levels of pregnant women presenting with such lifestyle conditions may be subject to close monitoring.

show abstract

Section: Discussionmentioning

confidence: 99%