Physical Activity Programs during Pregnancy Are Effective for the Control of Gestational Diabetes Mellitus

Abstract

Gestational diabetes mellitus has an incidence of 14% worldwide and nursing is responsible for its monitoring during pregnancy. Excessive weight gain during pregnancy is directly related to gestational diabetes mellitus development. Gestational diabetes mellitus (GDM) has negative repercussions on the evolution of the pregnancy and the fetus. The objective of this systematic review is to establish how physical activity influences pregnant women with gestational diabetes mellitus and to analyze what benefits physical activity has in the control of gestational diabetes mellitus. A systematic search was carried out in different databases (Cochrane, Superior Council of Scientific Investigations (CSIC), EBSCOhost, Pubmed, Scopus, Web os Science, and Proquest) for papers published within the last 12 years, taking into account different inclusion and exclusion criteria. Six randomized controlled studies and one observational case-control study of a high quality were selected. Fasting, postprandial glucose and HbcA1 were assessed, as well as the requirement and amount of insulin used. Thus, there is a positive relationship between the performance of physical activity and the control of gestational diabetes mellitus. Resistance, aerobic exercise, or a combination of both are effective for the control of glucose, HbcA1, and insulin. Due to the variability of the exercises of the analyzed studies and the variability of the shape of the different pregnant women, it does not permit the recommendation of a particular type of exercise. However, any type of physical activity of sufficient intensity and duration can have benefits for pregnant women with GDM. Pregnant women with gestational diabetes mellitus should exercise for at least 20–50 min a minimum of 2 times a week with at a least moderate intensity.

Improvement Effect of Metformin on Female and Male Reproduction in Endocrine Pathologies and Its Mechanisms

“…GDM is recognized on average in 10–20% of pregnant women, and the incidence is largely depends on diagnostic criteria and genetic, environmental and ethnic factors [ 319 , 320 , 321 ]. The dietary and exercise interventions are often used to prevent and treat GDM and improve pregnancy [ 317 , 322 , 323 ], but such interventions are effective only when used concurrently, and with pharmacological intervention [ 322 , 324 ]. Combining diet and exercise with vitamin D and myo-inositol supplement has been shown to be effective [ 324 , 325 , 326 , 327 ].…”

The Role of Lifestyle Intervention in the Prevention and Treatment of Gestational Diabetes

“…79,[87][88][89][90][91] Three systematic reviews have summarized the evidence relating to the role of physical activity during pregnancy in the management of GDM since 2015. 90,92,93 These reviews included 13 RCTs (N ¼ 805 women) 90,92,93 and one case-control study (N ¼ 30 women). 93 The majority of the included studies examined the effect of exercise as an "adjunct" treatment to dietary advice, support or counseling and/or pharmacotherapy, and/or standard care.…”

“…90,92,93 These reviews included 13 RCTs (N ¼ 805 women) 90,92,93 and one case-control study (N ¼ 30 women). 93 The majority of the included studies examined the effect of exercise as an "adjunct" treatment to dietary advice, support or counseling and/or pharmacotherapy, and/or standard care. For this reason, it remains difficult to determine the independent effect of exercise as treatment of GDM, based on the current literature.…”

“…92 However, when exercise training was used as an "adjunct" treatment, there were significant inverse relationships between exercise and several indicators of glucose control. 90,93 For example, Brown et al found improvements in fasting blood glucose (mean difference (MD) -0.31 mmol/L, 95% CI: -0.56 to -0.05, I 2 ¼ 82%) and glycated hemoglobin (MD -0.33%, 95% CI: -0.48 to -0.18, I 2 ¼ 60%) when exercise training was included in the intervention, compared with control interventions. 92 There was also a tendency for reduced need for insulin therapy (OR: 0.59, 95% CI: 0.28-1.22).…”

Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol

“…There are studies to guide interventions and the promotion of PA among pregnant women in different countries around the world [11,51,52,54,[65][66][67][68]73,76,[84][85][86][87][88][89], with varying degrees of PA participation and with underpinning reasons for and against PA participation during pregnancy. However, PA among South African women is sparsely studied; and the few studies [2,53,56,57,77] failed to utilise a large sample, with a heterogeneous population, and were conducted in only two provinces and/or urban geographical settings.…”