妊娠糖尿病患者的睡眠持续时间与其血糖控制情况间的相关性研究

Correlation between sleep lasting time and blood glucose control in patients with gestational diabetes mellitus

目的研究妊娠糖尿病(GDM)患者的睡眠状况与其血糖控制情况间的关系。方法将临床新近诊断为GDM,且未开始进行胰岛素或格列本脲治疗的孕产妇纳入研究。指导所有患者正确使用血糖仪及遵循GDM饮食原则。所有患者连续7d记录睡眠日志,包括上床时间和觉醒时间。使用线性混合模型分析GDM患者睡眠持续时间与其清晨空腹血糖及餐后1h血糖浓度间的关系。结果最终收集65例连续7d完整的睡眠记录表和血糖检测值。睡眠时间缩短与空腹和餐后1h血糖浓度呈显著负相关。在调整年龄、孕龄和体质量指数后,睡眠持续时间每增加1h则空腹血糖明显下降,二者呈显著相关[-2.13mg/dL,95%CI(-3.98,-0.20)],与此同时,餐后血糖浓度也明显下降,同样呈显著相关[午餐-4.52mg/dL,95%CI(-8.75,-0.50)vs.晚餐-5.87 mg/dL,95%CI(-9.40,-2.73)]。结论 GDM患者的睡眠持续时间缩短与血糖控制不佳密切相关。告知GDM患者充足睡眠的重要性的同时及早发现和治疗存在睡眠障的患者可以优化其血糖控制水平。

Objective To investigate the relationship between sleep status and blood glucose control in the patients with ges- tational diabetes mellitus （GDM）. Methods The pregnant women and parturients clinically newly diagnosed as GDM without start- ing insulin or glibenclamide treatment were included in this study. The subjects were instructed to correctly use the glucometer and comply with the GDM dietary principles. All subjects recorded the sleep log for consecutive 7 d,including the time going to bed and wake time. The linear mixed model was used to analyze the relationship between the sleep lasting time with morning fasting blood glucose and postprandial 1 h blood glucose level. Results The complete sleep logs of consecutive 7 d and blood glucose detection values were finally collected from 65 subjects. The sleep duration shortening had significantly negative correlation with fasting and postprandial 1 h blood glucose levels. After adjusting age, gestational age and BMI, every increase 1 h of sleep lasting time, the fast- ing blood glucose level was significantly decreased, there was significant correlation between them[-2.13 mg/dL, 95 %CI（- 3.98, -0.20）] ,meanwhile postprandial glucose level was also decreased, they were significant correlation as well[lunch -4.62 mg/dL, 95~CI （-8.75,-0.50） vs. dinner -6.07 mg/dL,95%CI（-9. 40,-2. 73）]. Conclusion The sleep lasting time shortening is closely correlated with poor glucose control in the patients with GDM. Informing GDM patients the importance of sufficient sleep, meanwhile early finding and treating the patients with existing sleep disorder can optimize their blood glucose control level.