The metabolic and circadian signatures of gestational diabetes in the postpartum period characterised using multiple wearable devices.
| Autor: | Phillips NE; Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland.; Laboratories of Neuroimmunology, Center for Research in Neuroscience and Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.; The Thoracic and Endocrine Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland., Mareschal J; Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland.; Gestational Diabetes Clinic, Service of Obstetrics, Department of Women-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.; Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland., Biancolin AD; The Thoracic and Endocrine Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland.; iGE3 Center, Geneva, Switzerland., Sinturel F; The Thoracic and Endocrine Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland.; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland.; iGE3 Center, Geneva, Switzerland., Umwali S; Gestational Diabetes Clinic, Service of Obstetrics, Department of Women-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland., Blanc S; Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland.; Department of Psychiatry, Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland., Hemmer A; Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland., Naef F; Institute of Bioengineering, School of Life Sciences, EPFL (Ecole Polytechnique Fédérale de Lausanne), Lausanne, Switzerland., Salathé M; Digital Epidemiology Lab, School of Life Sciences, School of Computer and Communication Sciences, EPFL (Ecole Polytechnique Fédérale de Lausanne), Lausanne, Switzerland., Dibner C; The Thoracic and Endocrine Surgery Division, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland. charna.dibner@unige.ch.; Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland. charna.dibner@unige.ch.; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland. charna.dibner@unige.ch.; iGE3 Center, Geneva, Switzerland. charna.dibner@unige.ch., Puder JJ; Gestational Diabetes Clinic, Service of Obstetrics, Department of Women-Mother-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. jardena.puder@chuv.ch., Collet TH; Service of Endocrinology, Diabetology, Nutrition and Therapeutic Education, Geneva University Hospitals, Geneva, Switzerland. tinh-hai.collet@hug.ch.; Diabetes Centre, Faculty of Medicine, University of Geneva, Geneva, Switzerland. tinh-hai.collet@hug.ch. |
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| Jazyk: | angličtina |
| Zdroj: | Diabetologia [Diabetologia] 2024 Nov 12. Date of Electronic Publication: 2024 Nov 12. |
| DOI: | 10.1007/s00125-024-06318-x |
| Abstrakt: | Aims/hypothesis: Gestational diabetes mellitus (GDM) affects 14% of all pregnancies worldwide and is associated with cardiometabolic risk. We aimed to exploit high-resolution wearable device time-series data to create a fine-grained physiological characterisation of the postpartum GDM state in free-living conditions, including clinical variables, daily glucose dynamics, food and drink consumption, physical activity, sleep patterns and heart rate. Methods: In a prospective observational study, we employed continuous glucose monitors (CGMs), a smartphone food diary, triaxial accelerometers and heart rate and heart rate variability monitors over a 2 week period to compare women who had GDM in the previous pregnancy (GDM group) and women who had a pregnancy with normal glucose metabolism (non-GDM group) at 1-2 months after delivery (baseline) and 6 months later (follow-up). We integrated CGM data with ingestion events recorded with the smartphone app MyFoodRepo to quantify the rapidity of returning to preprandial glucose levels after meal consumption. We inferred the properties of the underlying 24 h rhythm in the baseline glucose. Aggregating the baseline and follow-up data in a linear mixed model, we quantified the relationships between glycaemic variables and wearable device-derived markers of circadian timing. Results: Compared with the non-GDM group (n=15), the GDM group (n=22, including five with prediabetes defined based on fasting plasma glucose [5.6-6.9 mmol/l (100-125 mg/dl)] and/or HbA Conclusions/interpretation: We reveal GDM-related postpartum differences in glucose variability and 24 h rhythms, even among women clinically considered to be normoglycaemic. Our results provide a rationale for future interventions aimed at improving glucose variability and encouraging earlier daily behavioural patterns to mitigate the long-term cardiometabolic risk of GDM. Trial Registration: ClinicalTrials.gov no. NCT04642534. Competing Interests: Acknowledgements The authors wish to thank all participants and their families, the clinical team at the Maternity ward and Gestational Diabetes clinic, CHUV, the laboratory team at the Serum Biobank, CHUV, Y. Dibner at EPFL for the RedCap development, the Clinical Trial Unit at CHUV, the team at Digital Epidemiology laboratory, EPFL and the annotators of all recorded collected food and drink pictures via the MyFoodRepo app. Data availability The data are available upon reasonable request to the corresponding authors. Funding Open access funding provided by University of Geneva. This project was supported by the Leenaards Foundation (THC, JJP, CD), the Vontobel Foundation (THC, CD), the Swiss Life Jubiläumsstiftung Foundation (THC, FS), the Swiss Society of Endocrinology and Diabetes (THC, FS, NEP) and the Hjelt Foundation (NEP). THC’s research is supported by grants from the Swiss National Science Foundation (SNSF, PZ00P3-167826, 32003B-212559), the Nutrition 2000plus Foundation and the Medical Board of the Geneva University Hospitals. CD’s research is supported by SNSF grants 310030-184708 and 310030-219187, the Vontobel Foundation, the Olga Mayenfisch Foundation, Ligue Pulmonaire Genevoise, Swiss Cancer League (KFS-5266-02-2021-R), the Velux Foundation, the ISREC Foundation and the Gertrude von Meissner Foundation. JJP’s research is supported by SNSF grant 32003B-176119, the Gottfried und Julia Bangerter-Rhyner Foundation, an unrestricted educational grant from Novo Nordisk and a grant from the Dreyfus Foundation. Authors’ relationships and activities The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Contribution statement NEP, CD, JJP and THC conceptualised the study. NEP, CD, JJP and THC acquired funding. NEP, JM, ADB, FS, SU, FN, CD, JJP and THC developed and implemented the methodology. JM, SU, AH, JJP and THC collected the data. NEP, ADB, SB, FN, MS and THC analysed the data. NEP, MS and THC developed/worked on the software. NEP and THC created the visualisation. NEP and THC wrote the original draft manuscript. CD, JJP and THC performed supervision and project administration. All authors have read, edited and agreed to the published version of the manuscript. NEP, CD, JJP and THC are responsible for the integrity of the work as a whole. (© 2024. The Author(s).) |
| Databáze: | MEDLINE |
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