Effects of structured exercise regime on Glycosylated Hemoglobin and C reactive protein in patients with Gestational Diabetes Mellitus - A randomized controlled trial

Qazi, Wardah Ajaz; Babur, Muhammad; Malik, Arshad Nawaz; Begum, Rahima

doi:10.12669/pjms.36.7.2488

Cited by 5 publications

(4 citation statements)

References 15 publications

(21 reference statements)

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“…[13] A research was performed on GDM showed that structured exercise improve the liver and renal functions and help to improve glucose level in the body. [14] The results of current research in which APGAR Score at 1 min and 5 min recorded, p-value had shown signi cant difference in Group-A and B. The studies of Kokic et al in 2018, in women with gestational diabetes where the one group received antenatal care and regular exercises with 30 mins of brisk walk, but other group was given only antenatal care.…”

Section: Discussionmentioning

confidence: 60%

Effects of Antenatal Exercises on Clinical Outcomes in Pregnant Females with Gestational Diabetes Mellitus: A Randomized Controlled Trial

Anum

Fahad

Ahmad

et al. 2022

Preprint

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BackgroundGestational diabetes mellitus is the most common complication that affects the health of the child and mother during pregnancy. The study was aimed to determine the effects of Antenatal exercises on glucose levels, mode of delivery and APGAR Score in females with gestational diabetes mellitus.MethodsThis Randomized controlled trial study was conducted on 72 pregnant females at department of Gynecology and Obstetrics, Mian Munshi DHQ Hospital, Lahore. The females in 20-35 years of age, at 20-24 weeks of gestation with diagnosed GDM were included to make sure that all the data could find out easily and genuinely. Group-A received Routine Physical Therapy with Insulin therapy and Group –B- received Antenatal exercises along with Insulin therapy. Total 3 sessions per week were given to the patients for 60 mins, from 20- 24 weeks of gestation, in which 1st six session given to the patient under supervision of therapist, remaining sessions was performed by the patients at home till the time of delivery. The outcome tools were APGAR scale for neonatal outcome and HbAc1 test % was measured for Glucose level. The data was entered and analyzed using SPSS Version 24. Nonparametric Mann Whitney u test was used to determine mean difference of glucose level and APGAR Scores between groups due to abnormal distribution of data. Chi square test was applied for mode of delivery among both groups. P-value ≤0.05 was considered statistically significant.ResultsMajority (69.4%) of the participants in experimental group had normal delivery, while 30.6% underwent C-section (P=0.00).The APGAR Score at 5 min was 8.86 ± 1.24(P=0.035) in Group A and9.38 ±1.07 in Group B(P=0.030). The HbAc1 was 6.25 ±0.98 in group A and in Group-B was 5.43 ±1.14(P=0.000).ConclusionAntenatal care is one of the essential components for pregnancy related outcomes. The antenatal exercise can decrease the chances of cesarean section, glucose level and APGAR score can be improved with use of antenatal exercise.Initial date of registration: 21/04/2021, Final Date of registration: 26/04/2021 ,Registration no: NCT04859348 ‘ClinicalTrials.gov Protocol Registration and Results System (PRS).’

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Section: Discussionmentioning

confidence: 60%

Effects of Antenatal Exercises on Clinical Outcomes in Pregnant Females with Gestational Diabetes Mellitus: A Randomized Controlled Trial

Anum

Fahad

Ahmad

et al. 2022

Preprint

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“…We believe that starting exercises after the diagnosis is necessary. Moreover, aerobic or resistive exercises have mostly been preferred for improving glycemic control in the treatment of gestational diabetes [20,21,22]. Resistance exercise at a moderate intensity was proven to be successful by Yaping et al [23] in lowering blood glucose levels in women with GDM.…”

Section: Discussionmentioning

confidence: 99%

Comparison of home exercise under supervision and self home exercise in pregnant women with gestational diabetes: randomized controlled trial

Menek,

Kaya

2024

Arch Gynecol Obstet

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Objective Exercise programs at home are successful in treating gestational diabetes by controlling blood glucose. The aim is to compare the e cacy of the self-directed home exercise program, the standard care alone and the supervised home exercise program in pregnant women with gestational diabetes on blood glucose, quality of life and pregnancy outcomes. Methods This randomized, parallel, single-blind study included forty-ve pregnant women who were 24-28 weeks of gestation. Participants were randomly divided into the supervised home exercise group (SHEG), home exercise group (HEG) and control group (CG). While the home exercises program was taught and controlled by a physiotherapist in SHEG, the home exercise brochure was given without any training by the gynecologist in HEG. Control group maintained their usual daily care. The home exercise intervention included low to moderate structured exercise performed three days per week for 8 weeks. Their glucose responses, quality of life and pregnancy outcomes were assessed pre-and post intervention.Results Fasting glucose and 2 h postprandial glucose levels were improved statistically in SHEG and HEG groups after intervention (p<0.05). Differences in SHEG were statistically higher than HEG (p<0.017). When the HEG and CG were compared, there was no superiority between the two groups in all outcome measures except the physical health. Additionally, there were no statistically signi cant differences in values of cesarean birth and preterm birth between groups (p>0.05).Conclusions This study revealed that pregnant women should be under the supervision of physiotherapists while doing home exercises.Clinical Trial Registration The trial was approved by the registration of ClinicalTrials.gov and registration number: NCT05195333. What does this study add to the clinical workThe home exercises given with physiotherapist training during pregnancy were better than self-home exercises and standard care only in terms of improvement of blood glucose level and quality of life.

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“…Six of the included studies were pilot studies or underpowered to determine significant differences for the primary outcomes of this review [ 35 , 37 , 43 , 45 , 47 , 51 ]. Furthermore, subgroup analysis based on common moderators of GDM risk could not be performed for some of the outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, a very- or low-GRADE quality score for most outcomes (supplements: FPG and PPG; diet: FPG, PPG, and HbA1c; exercise: PPG, HbA1c, and HOMA-IR) due to limitations in the design of included studies (e.g., allocation concealment, lack of blinding of either outcome assessors or participants, reporting of adherence to the intervention) could explain the lack of difference between intervention and control. The strengths of this review should be noted, as far as we know, this is the first SRMA that shows the benefits of supplement-, dietary-, and exercise-based interventions on measures of glycemic control in GDM, including more recent studies not included by the preceding SRMAs [ 26 , 28 , 31 , 42 , 51 ]. Overall this SRMA included a large number of participants with varied backgrounds and examines the effectiveness of lifestyle interventions on maternal glycemic control, ultimately reducing the risk of adverse perinatal outcomes.…”

Section: Discussionmentioning

confidence: 99%

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

et al. 2023

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Diabetes disrupts one in six pregnancies, bestowing immediate and long-term health risks to mother and child. Diet and exercise are commonly prescribed to control dysglycemia, but their effectiveness across sub-populations and types of diabetes (type-1; type-2; or gestational diabetes mellitus, GDM) is uncertain. Therefore, a systematic review and meta-analysis on the effect of diet and/or exercise on glycemia in pregnant women with diabetes was conducted. Random effects models were used to evaluate effect sizes across studies and anticipated confounders (e.g., age, ethnicity, BMI). Of the 4845 records retrieved, 26 studies (8 nutritional supplements, 12 dietary, and 6 exercise interventions) were included. All studies were conducted in patients with GDM. Overall, supplement- and exercise-based interventions reduced fasting glucose (−0.30 mmol/L; 95% CI = −0.55, −0.06; p = 0.02; and 0.10 mmol/L; 95% CI = −0.20, −0.01; p = 0.04); and supplement- and diet-based interventions reduced HOMA-IR (−0.40; 95% CI = −0.58, −0.22; p < 0.001; and −1.15; 95% CI = −2.12, −0.17; p = 0.02). Subgroup analysis by confounders only confirmed marginal changed effect sizes. Our results suggest a favorable role of certain nutritional supplements, diet, and exercise practices on glycemia in women with GDM and underline a lack of evidence in ~20% of other diabetes-related pregnancies (i.e., women with pre-existing diabetes).

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Effects of structured exercise regime on Glycosylated Hemoglobin and C reactive protein in patients with Gestational Diabetes Mellitus - A randomized controlled trial

Cited by 5 publications

References 15 publications

Effects of Antenatal Exercises on Clinical Outcomes in Pregnant Females with Gestational Diabetes Mellitus: A Randomized Controlled Trial

Effects of Antenatal Exercises on Clinical Outcomes in Pregnant Females with Gestational Diabetes Mellitus: A Randomized Controlled Trial

Comparison of home exercise under supervision and self home exercise in pregnant women with gestational diabetes: randomized controlled trial

Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

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