(1267) Phenotyping glucose, physical activity, and sleep patterns using wearables in gestational diabetes

Limited data exists on the impact of physical activity and sleep on dysglycemia in pregnancies with gestational diabetes mellitus (GDM).  We evaluated the feasibility of using continuous glucose monitors (CGM) and accelerometers to phenotype participants with and without GDM during pregnancy and early postpartum.

Study Design:

We conducted a prospective cohort study of pregnant (26-32 wks) and postpartum (4-12 wks) patients with and without GDM who wore an accelerometer and a CGM for 14 days. Metrics included days of device usage and user acceptability via the 100-point System Usability Scale (SUS) survey. Kruskal-Wallis and post-hoc Dunn’s tests were used to identify differences amongst the four groups.

Results:

24 participants enrolled in the study (11 pregnant GDM, 3 postpartum GDM, 5 pregnant without GDM, and 5 postpartum without GDM) (Table 1). CGM and accelerometry usage during day and sleep hours was assessed (Table 1). On the SUS survey, participants scored the accelerometer 68±27 points and CGM 70±27 points out of 100, with 91% of participants having a net positive opinion (SUS >50) of both devices (Figure 1).

There were significant differences in steps, sleep duration, and time above 140 mg/dL (all p< 0.05; Table 1) between groups. Postpartum controls had more steps (11624 [11252,12235] vs 7910 [7239,9259]; p=0.03) and lower sleep duration (4.7 [4.6,5.1] hrs vs 7.2 [6.5,7.6] hrs; p=0.01) than pregnant GDM participants. Postpartum GDM group had a higher time above 140 mg/dL than controls (3.4 [2.4,9.9]% vs 0 [0,0]%; p=0.03), indicating possible unresolved dysglycemia. 86% of participants walked over 7,000 steps daily, while only 41% achieved recommended 7 hours of sleep. CGM data revealed all participants spent more than the recommended 70% of time in euglycemia.

Conclusion:
Simultaneous use of accelerometry and CGM was acceptable for participants with or without GDM during pregnancy and early postpartum. These devices can enhance understanding of exercise, sleep, and glycemia relationships, aiding management of individuals at highest risk of adverse outcomes.