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null What do we know about sleep apnea, pregnancy and gestational diabetes?

RI-MUHC researchers find link that may lead to better health for mother and baby

Nov. 9, 2020

Source: RI-MUHC. In Diabetes Awareness Month, as November 14—World Diabetes Day—approaches, scientists at the Research Institute of the McGill University Health Centre (RI‑MUHC) are weighing in on issues of paramount importance to the diabetes world. One group has addressed a concern that women with gestational diabetes have increased risk of complications during pregnancy and delivery, and their children are at greater risk of developing type 2 diabetes later in life.

Gestational diabetes causes elevated blood glucose levels during pregnancy and is usually treated by lifestyle changes such as increased physical activity and healthy eating. Sleep, however, is not always prioritized, despite the fact that sleep apnea has strong links with type 2 diabetes and is quite prevalent in pregnancy. Sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep. It can occur in 17 to 45 percent of pregnant women by the third trimester.

In a study recently published in the journal Chest, this group of researchers has addressed whether untreated sleep apnea in pregnant women with gestational diabetes is associated with higher glucose levels, particularly at night. Led by Sushmita Pamidi, MD, scientist at the RI‑MUHC and assistant professor in the Faculty of Medicine and Health Sciences, McGill University, the researchers used a small sensor under the skin to monitor glucose levels every five minutes over a 72-hour period.

Former RI-MUHC trainee and first author of study, Raphieal Newbold, and RI-MUHC scientist Dr. Sushmita Pamidi
Former RI-MUHC trainee and first author of study, Raphieal Newbold, and RI-MUHC scientist Dr. Sushmita Pamidi

“Our team found that increasing severity of sleep apnea in pregnant women with gestational diabetes was, in fact, linked with higher glucose levels at night,” says Dr. Pamidi, who is a member of the Translational Research in Respiratory Diseases Program and conducts research at the Centre for Outcomes Research and Evaluation at the RI-MUHC. “However, screening for sleep apnea and measurement of glucose levels at night are not common clinical practices in treatment.”

“It is possible that improved glucose control in pregnancy could result from detection and treatment of sleep apnea,” says Raphieal Newbold, M.Sc., a former trainee at the RI-MUHC and first author of the study. “This could lead to improved overall outcomes for mother and baby.”

The study suggests pursuing larger interventional studies to determine if treatment of sleep apnea can improve glucose control during pregnancy.

Adds Dr. Pamidi, “Overall, we need to think more about the importance of sleep disorders in pregnant women. This may be a missing link in the lifestyle recommendations for this population.”

About the study:

Raphieal Newbold, [then] B.Sc., Andrea Benedetti, PhD, R. John Kimoff, MD, Sara Meltzer, MD, Natasha Garfield, MD, Kaberi Dasgupta, MD, Robert Gagnon, MD, Lorraine Lavigne, RN, Allen Olha RPSGT, Evelyne Rey, MD, Sushmita Pamidi, MD. Maternal Sleep-Disordered Breathing in Pregnancy and Increased Nocturnal Glucose Levels in Women with Gestational Diabetes. CHEST. July 2020. https://doi.org/10.1016/j.chest.2020.07.014

Increasing severity of sleep apnea (shown as Apnea Hypopnea Index, AHI) in pregnant women with gestational diabetes is linked to higher blood glucose levels at night
Increasing severity of sleep apnea (shown as Apnea Hypopnea Index, AHI) in pregnant women with gestational diabetes is linked to higher blood glucose levels at night

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