A prospective study of the relationships between movement and glycemic control during day and night in pregnancy

Masoud Behravesh,Helena Strevens,Tibor V Varga,Paul W Franks,Ómar S Gunnarsson,Angela C Estampador,Juan Fernandez-Tajes,Simon Timpka

doi:10.1038/s41598-021-03257-0

Abstract

Both disturbed sleep and lack of exercise can disrupt metabolism in pregnancy. Accelerometery was used to objectively assess movement during waking (physical activity) and movement during sleeping (sleep disturbance) periods and evaluated relationships with continuous blood glucose variation during pregnancy. Data was analysed prospectively. 15-women without pre-existing diabetes mellitus wore continuous glucose monitors and triaxial accelerometers from February through June 2018 in Sweden. The relationships between physical activity and sleep disturbance with blood glucose rate of change were assessed. An interaction term was fitted to determine difference in the relationship between movement and glucose variation, conditional on waking/sleeping. Total movement was inversely related to glucose rate of change (p < 0.001, 95% CI (− 0.037, − 0.026)). Stratified analyses showed total physical activity was inversely related to glucose rate of change (p < 0.001, 95% CI (− 0.040, − 0.028)), whereas sleep disturbance was not related to glucose rate of change (p = 0.07, 95% CI (< − 0.001, 0.013)). The interaction term was positively related to glucose rate of change (p < 0.001, 95% CI (0.029, 0.047)). This study provides temporal evidence of a relationship between total movement and glycemic control in pregnancy, which is conditional on time of day. Movement is beneficially related with glycemic control while awake, but not during sleep.

Highlights

Both disturbed sleep and lack of exercise can disrupt metabolism in pregnancy
2 months, and insufficient activity and glucose monitoring data were available for a third woman
We show a relationship between total movement and improved glycemic control in pregnancy and that this association is contingent on whether movement occurs during waking or sleeping periods

Summary

Introduction

Accelerometery was used to objectively assess movement during waking (physical activity) and movement during sleeping (sleep disturbance) periods and evaluated relationships with continuous blood glucose variation during pregnancy. The relationships between physical activity and sleep disturbance with blood glucose rate of change were assessed. Stratified analyses showed total physical activity was inversely related to glucose rate of change (p < 0.001, 95% CI (− 0.040, − 0.028)), whereas sleep disturbance was not related to glucose rate of change (p = 0.07, 95% CI (< − 0.001, 0.013)). Endocrine adjustments take place progressively from mid- to late-pregnancy During this period maternal peripheral insulin sensitivity declines and is paralleled by increases in insulin release and blood insulin c oncentrations[1]. Short sleep duration in pregnancy[13] and subjectively assessed poor sleep quality have been associated with elevated risk of GDM, but where sleep quality has been objectively assessed, results are inconclusive[14]

Methods

Results

Conclusion