Gestational diabetes is a common complication in pregnancy that is characterized by an increase in blood sugar levels and increases the risk of developing metabolic diseases such as type 2 diabetes. It is estimated that it affects around 14% of pregnant women. globally, but the impact it has on a woman’s health after giving birth to her baby is not yet fully understood.
To explore this area, a team from the University of Geneva (UNIGE), in collaboration with the University Hospital of Lausanne (CHUV), the University Hospitals of Geneva (HUG), the University of Lausanne (UNIL) and the EPFL, used devices High-precision wearables to continuously monitor glucose dynamics, physical activity, sleep patterns, and heart rate in women with and without a diagnosis of gestational diabetes.
Researchers have found evidence of persistent alterations in glucose regulation after childbirth in women who had had gestational diabetes, even though their conventional clinical measurements appeared normal. The results of the study have been published in the journal Diabetologia and highlight the need for adequate follow-up even after delivery.
“Contrary to the belief that gestational diabetes disappears after childbirth, we now know that it can increase the long-term risk of developing type 2 diabetes, as well as other cardiometabolic disorders, by up to 10 times,” said Tinh-Hai Collet, assistant professor. in the Department of Medicine and the Diabetes Center of the Faculty of Medicine of the UNIGE and doctor in the Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education of Patients at the HUG in a note press release released by UNIGE.
Increased body weight and dysfunction in circadian rhythms
To better assess this risk, the team of scientists monitored changes in physiological markers and behavioral habits of women in the postpartum period. The study included 22 women who had had gestational diabetes and compared them with 15 women with normal glucose metabolism during pregnancy, which revealed that those who had gestational diabetes in the previous pregnancy had a higher body weight and, Although they consumed fewer carbohydrates, it took longer for their blood glucose levels to return to normal after meals. Furthermore, their daily blood sugar rhythms showed alterations, suggesting a dysfunction in their internal clocks or circadian rhythms.
“There are two aspects to glucose dynamics. After meals, a temporary increase is generally observed. Additionally, there is a 24-hour blood glucose cycle influenced by circadian rhythms. Both aspects are altered in women who have had gestational diabetes,” explains Jardena Puder, associate professor at the UNIL Faculty of Biology and Medicine, doctor in the gestational diabetes consultation at the Women-Mother-Child Department of the CHUV and co-author of the study.
The researchers tracked the participants using state-of-the-art wearable devices capable of continuously measuring blood glucose levels, eating habits, physical activity, sleep and heart rate for 24 hours. These measurements were carried out over a two-week period, between one and two months after delivery, and were repeated six months later.
“Our approach shows that gestational diabetes does not completely disappear after childbirth, but rather an alteration in glucose regulation persists that could have long-term consequences”
“We integrate continuous glucose monitoring with a food diary application on the smartphone to analyze glucose dynamics after meals. These new technologies made a difference in the study,” says Charna Dibner, associate professor and principal investigator in the Division of Thoracic and Endocrine Surgery in the Department of Surgery at HUG, in the Department of Cellular Physiology and Metabolism, and the Diabetes Center. from the UNIGE Faculty of Medicine, and co-author of the study.
Women who have had gestational diabetes continue to show alterations in the regulation of their blood glucose levels, even those with normal values in their traditional glucose tests. “Conventional clinical monitoring techniques are adequate, but our approach shows that gestational diabetes does not completely disappear after delivery; An alteration in glucose regulation persists, which could have long-term consequences, even when standard blood glucose values are normal,” insists Tinh-Hai Collet.
In this context, the study authors suggest that monitoring glucose variability in the postpartum period could help identify women at risk. These measurements could serve as markers of possible complications, although their long-term relationship with the development of type 2 diabetes remains to be defined.
