Thanks to a wearable device, a team from UNIGE, CHUV, HUG, UNIL, and EPFL has identified persistent dysfunctions in glucose regulation among women who have experienced gestational diabetes.
Illustrative image Pixabay
A pregnancy-related complication, gestational diabetes increases the risk of developing a metabolic disorder, notably type 2 diabetes. However, its effects after childbirth remain poorly understood. To address this gap, a team from the University of Geneva (UNIGE), in collaboration with the Vaud University Hospital Center (CHUV), Geneva University Hospitals (HUG), the University of Lausanne (UNIL), and EPFL, utilized wearable devices to monitor glucose dynamics, physical activity, sleep, and heart rate in women with or without a history of gestational diabetes.
The results reveal that disruptions in blood sugar regulation persist after childbirth in women affected by this condition, despite regular clinical data appearing normal. This research, published in the journal
Diabetologia, advocates for tailored follow-up care even after delivery.
Gestational diabetes (GD) occurs during pregnancy and affects around 14% of pregnant women globally, and 10% in Switzerland. It is characterized by elevated blood glucose levels. “Contrary to the common belief that GD disappears after childbirth, we now know that it can increase the long-term risk of type 2 diabetes by up to tenfold, as well as the onset of other cardiometabolic diseases,” says Tinh-Hai Collet, assistant professor in the Department of Medicine and the Diabetes Faculty Center at UNIGE's Faculty of Medicine, and an associate physician in the Endocrinology, Diabetology, Nutrition, and Patient Therapeutic Education Service at HUG.
Disrupted glucose dynamics
With a team comprised of scientists from UNIGE, CHUV, HUG, UNIL, and EPFL, the researcher sought to better assess this risk by tracking physiological markers and behavioral habits in women during the postpartum period. The study shows that women who had gestational diabetes exhibit higher body weight. Moreover, even with lower carbohydrate intake — encompassing foods like bread, pasta, rice, or added sugars, all of which convert into glucose — their blood sugar takes longer to return to normal after meals. Their daily blood sugar rhythms are also disrupted, suggesting a malfunction in their internal clocks or circadian rhythms.
“The physiological dynamics of blood sugar include two aspects. After meals, for instance, a transient increase is generally observed. There is also a 24-hour glucose cycle influenced by circadian rhythms. Both of these dynamics are disturbed in women who have had gestational diabetes,” states Jardena Puder, associate professor at the University of Lausanne (UNIL) Faculty of Biology and Medicine, associate physician at the Gestational Diabetes Clinic of the Obstetrics Service in the Women-Mother-Child Department of CHUV, and co-author of the study.
Continuous monitoring
The researchers monitored women recruited from CHUV, with or without a diagnosis of gestational diabetes, using state-of-the-art wearable devices capable of measuring blood sugar, dietary habits, physical activity, sleep, and heart rate in real-time over a 24-hour period. “For example, we integrated blood glucose data with a smartphone food journal app to analyze glucose dynamics after meals. It is truly these new technologies that made the difference in this study,” explains Charna Dibner, associate professor in the Thoracic and Endocrine Surgery Service of the Surgery Department at HUG, in the Department of Cellular Physiology and Metabolism and the Diabetes Faculty Center at UNIGE's Faculty of Medicine, and co-author of the study.
These measurements were taken over two weeks, one to two months after childbirth, and then repeated six months later. The study included 22 women with gestational diabetes, compared to 15 women with normal glucose metabolism during their prior pregnancy.
New markers identified
Women who had GD continue to exhibit altered glucose regulation, even those with normal blood glucose values in conventional blood tests. “The conventional techniques used today for clinical monitoring are adequate. However, our approach shows that gestational diabetes does not completely disappear after childbirth. A glucose regulation disorder persists. This could have long-term consequences, even when blood glucose values appear normal in tests,” emphasizes Tinh-Hai Collet.
This research suggests that monitoring glucose variability during the postpartum period could help identify women at risk. The measurements performed by the research team may serve as markers for potential complications, although these will need to be defined over the long term, particularly their link to the development of type 2 diabetes.