Number of parous events affects the association between physical exercise and glycemic control among women with gestational diabetes mellitus: A prospective cohort study

Wang, Ruiping; Yao, Fei; Sun, Ting; Yan, Qiang; Li, Huan; Tang, Yu Lan; Yang, Qing; Li, Bin; Adams, Roger; Han, Jie

doi:10.1016/j.jshs.2022.03.005

Journal of Sport and Health Science

2022

DOI: 10.1016/j.jshs.2022.03.005

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Number of parous events affects the association between physical exercise and glycemic control among women with gestational diabetes mellitus: A prospective cohort study

Ruiping Wang

Fei Yao

Ting Sun³

et al.

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Cited by 4 publications

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“…While the conclusions drawn by Wang et al 1 need further confirmation, recommending more exercise during pregnancy does not pose hazards or disadvantages. 6 , 7 , 9 Focusing on physical activity in maternal care seems important because a great proportion (39%) of the study participants reported physical activity times of less than 60 min per day.…”

mentioning

confidence: 88%

“…The study by Wang et al 1 showed that multiparous women were slightly more likely than primiparous women to have abnormal plasma glucose levels (40.0% vs . 37.5%).…”

mentioning

confidence: 99%

“…In the current issue of the Journal of Sport and Health Science , Wang et al 1 describe their prospective study, where they analyzed whether or not multiple pregnancies would influence glycemia and the glycemic response to physical exercise in gestational diabetes mellitus (GDM). 2 Multiparous women are known to be at a higher risk for GDM than primiparas.…”

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confidence: 99%

“…The beneficial effects of acute and chronic exercise during pregnancy on GDM have been well documented. 8 Findings by Wang et al 1 suggest that while at least 60 min of moderate intensity physical activity per day is needed for primiparous women with GDM, multiparous women should exercise more, with at least 90 min of moderate intensity physical activity per day needed to achieve a comparable glucose-lowering effect. Physical exercise thus appears to operate more efficiently in primiparous than multiparous women.…”

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confidence: 99%

“…Potential sources of bias include differences in age, degree of obesity, and socioeconomic status between primiparous and multiparous women as well as the reliance on self-reported physical activity and intensity data. A drawback of the study by Wang et al 1 was that diets were not monitored. However, the results leave open the possibility that previous pregnancy may impair insulin sensitivity and β-cell capacity to secrete insulin in subsequent pregnancies.…”

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confidence: 99%

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Do multiparous women need to work or exercise extra hard to control gestational diabetes?

Matikainen

Meri

2022

Journal of Sport and Health Science

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mentioning

confidence: 88%

“…The study by Wang et al 1 showed that multiparous women were slightly more likely than primiparous women to have abnormal plasma glucose levels (40.0% vs . 37.5%).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Do multiparous women need to work or exercise extra hard to control gestational diabetes?

Matikainen

Meri

2022

Journal of Sport and Health Science

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Identifying Discrepancies in Gestational Diabetes Mellitus Postpartum Follow-Up During Care Transitions

Strelow,

Herndon,

Ferrier

et al. 2023

J Prim Care Community Health

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Background: Gestational diabetes mellitus (GDM) is a common complication of pregnancy that carries lasting risks. For women who have a history of GDM, the risk of developing type 2 diabetes mellitus (T2DM) increases by 50 to 60%. To monitor and prevent the development of T2DM, guidelines suggest screening those with a history of GDM at 6-weeks and 3-years post-delivery. For patients with abnormal lab results at the 6-week mark, it is advised to complete lab work sooner, at the 1-year mark. Data suggests that these guidelines are not being followed globally, and most do not receive adequate screening for T2DM. Methods: A retroactive chart review of 203 women between 18 and 55 years old with a past medical history significant for GDM was conducted to determine if patients with GDM completed screening for T2DM at 6-week, 1-year, and 3-year timestamps post-delivery. Patient demographics (age, race, ethnicity, language), clinical characteristics (body mass index), provider gender, and whether prediabetes or T2DM developed were recorded. Patients who did not complete the required follow-up received educational materials via the online portal system, and hemoglobin A1c (HbA1c) screening tests were ordered. Results: Ninety days post-intervention, 38 patients (50%) completed the HbA1c screening test, which exceeded our goal of a 5% improvement. Age and BMI 1-year postpartum were found to be significant factors in whether a patient completed HbA1c screening, with 16/18 (89%) completing screening with a healthy BMI 1-year postpartum (18.5 ≤ BMI < 25.0) but only 11/41 (27%) completing screening for patients under 40 years with an unhealthy BMI 1-year postpartum. Of the 38 patients who completed HbA1c screening, 9 (23.7%) had abnormal screening results. Conclusion: Follow-up surveillance for T2DM among women with a history of GDM is poor. Electronic health records can be used to identify and rectify gaps in care. Dissemination of standardized educational materials and electronic order entry for patients improved screening between the handoff from obstetrics to primary care.

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More Physical Exercise is Required for Overweight or Obese Women with Gestational Diabetes Mellitus to Achieve Good Plasma Glucose Control During Pregnancy: Finding from a Prospective Cohort in Shanghai

Gao,

Zhang,

Kuai

et al. 2023

DMSO

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Objective This study was based on a gestational diabetes mellitus (GDM) cohort in Shanghai to examine the association between physical exercise and plasma glucose control among GDM women with and determine what the effects of pre-pregnancy body mass index (BMI). Methods In this study, GDM was diagnosed if the plasma glucose values at any of the following time points reached the diagnostic threshold: fasting blood glucose (5.1 mmol/L), 1-hour blood glucose (10.0 mmol/L), and 2-hour blood glucose (8.5 mmol/L) by 75 g oral glucose tolerance test (OGTT). Information on GDM women was extracted from the hospital’s health records and prenatal examination forms and was obtained through face-to-face interviews after delivery. A restricted cubic spline curve with four knots was used to flexibly model the relationship between the duration of moderate-intensity physical exercise and the percentage of abnormal plasma glucose among GDM patients with different BMI values. In this study, a P -value less than 0.05 (two-tailed) was considered as statistical significance. Results Among 1139 GDM women with GDM, the median percentage of abnormal plasma glucose (PG) was 40.0% (interquartile range (IQR): 20.0–66.7%), and the difference between overweight-obese group and underweight-normal group was statistically significant (50.0% vs 40.0%, P <0.001). In this study, engaging in more physical exercise during pregnancy contributed to a higher prevalence of satisfactory glycemic control, and women with BMI <25 kg/m 2 should engage in no less than 90 minutes of moderate-intensity physical activity per day to achieve satisfactory glycemic control (prevalence of abnormal PG <35%). However, over 120 minutes of daily moderate-intensity physical activity is required for GDM women with a BMI ≥25 kg/m 2 to achieve satisfactory glycemic control. Conclusion Overweight or obese women with GDM have a higher risk of poor glycemic control and require a longer duration of physical exercise to achieve the same level of blood glucose control.

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Number of parous events affects the association between physical exercise and glycemic control among women with gestational diabetes mellitus: A prospective cohort study

Cited by 4 publications

References 22 publications

Do multiparous women need to work or exercise extra hard to control gestational diabetes?

Do multiparous women need to work or exercise extra hard to control gestational diabetes?

Identifying Discrepancies in Gestational Diabetes Mellitus Postpartum Follow-Up During Care Transitions

More Physical Exercise is Required for Overweight or Obese Women with Gestational Diabetes Mellitus to Achieve Good Plasma Glucose Control During Pregnancy: Finding from a Prospective Cohort in Shanghai

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