Introduction & Objective: Sleep is a crucial lifestyle factor associated with cardiometabolic health, yet its role in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes (T2D) is underexplored. Our study investigated the associations between sleep, T2D risk, and metabolic biomarkers in these high-risk women.

Methods: We followed 2,999 women with a history of GDM in the Nurses’ Health Study II for incident T2D between 2001 and 2019. Sleep characteristics, health-related and other lifestyle factors were ascertained in 2001 questionnaire. Glucose metabolic biomarkers were measured in a subset of participants with available fasting blood samples collected between 2012 and 2014 (n=536). Cox regression models were used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of T2D. Least-squares means (95% CIs) of metabolic biomarker levels were estimated according to sleep characteristics.

Results: During a mean of 14.8 years of follow-up, 520 women developed T2D. Compared to sleeping 7-8 hours per day, shorter sleep duration (≤6 hours/day) was significantly associated with a higher risk of T2D, with an adjusted HR of 1.28 (95% CI = 1.03-1.58). Compared with rarely snoring, occasional and regular snoring were significantly associated with a higher T2D risk, with adjusted HR of 1.44 (95% CI = 1.11-1.86) and 1.52 (95% CI = 1.16-2.00), respectively. The highest risk of T2D was observed in obese women who experienced shorter sleep duration (HR=6.99, 95% CI = 4.62 - 10.6), compared with non-obese women who sleep 7-8 hours per day. Furthermore, significant positive associations were observed between more frequent snoring and increased levels of HbA1c, C-peptide, and insulin (all P-values<0.05).

Conclusion: Among women with a history of GDM, shorter sleep duration and more frequent snoring were significantly associated with increased risk of T2D and unfavorable cardiometabolic profile.

Disclosure

X. Yin: None. W. Bao: None. J. Yang: None. G. Yu: None. P. Liu: None. C. Zhang: None.

© 2024 by the American Diabetes Association
2024
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