Postprandial interval walking—effect on blood glucose in pregnant women with gestational diabetes

Andersen, Mette Bisgaard; Fuglsang, Jens; Ostenfeld, Eva Bjerre; Poulsen, Charlotte Wolff; Daugaard, Merete; Ovesen, Per

doi:10.1016/j.ajogmf.2021.100440

Cited by 9 publications

(12 citation statements)

References 38 publications

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“…Interestingly, many women reported that physical activity/walking after meals was an effective strategy for managing blood glucose. Although only a handful of small acute studies are available to support this, available studies have shown promising results with respect to the glucose-lowering benefits of performing one postprandial bout of exercise [ 34 , 35 , 36 ] or, alternatively, three shorter bouts of walking after main meals [ 37 ]. Although the results of this study include data from both pregnant and non-pregnant women, they highlight that the majority of women with current or previous GDM are not meeting the physical activity recommendations.…”

Section: Discussionmentioning

confidence: 99%

Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey

et al. 2023

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Background: Gestational diabetes mellitus (GDM) affects approximately one in six pregnancies, causing a significant burden on maternal and infant health. Lifestyle interventions are first-line therapies to manage blood glucose levels (BGLs) and prevent future cardiometabolic complications. However, women with GDM experience considerable barriers to lifestyle interventions; thus, the aim of this study was to determine how women with GDM manage their condition and to identify the primary supports and barriers to lifestyle intervention participation. Methods: An online cross-sectional survey of women in Australia with a history of GDM was conducted. Questions included participant demographics, strategies used to manage BGLs, physical activity and dietary habits, and barriers and supports to lifestyle interventions. Results: A total of 665 individuals consented and responded to the advertisement, of which 564 were eligible and provided partial or complete responses to the survey questions. Most respondents were between 35 and 39 years of age (35.5%), not pregnant (75.4%), working part-time (26.7%), university-educated (58.0%), and had only one child (40.1%). Most respondents managed their BGLs through diet (88.3%), with “low-carbohydrate” diets being the most popular (72.3%), and 46.2% of respondents were undertaking insulin therapy. Only 42.2% and 19.8% of respondents reported meeting the aerobic and strengthening exercise recommendations, respectively. Women with one child or currently pregnant expecting their first child were 1.51 times more likely (95% CI, 1.02, 2.25) to meet the aerobic exercise recommendations than those with two or more children. The most common reported barriers to lifestyle intervention participation were “lack of time” (71.4%) and “childcare” commitments (57.7%). Lifestyle interventions delivered between 6 and 12 months postpartum (59.0%), involving an exercise program (82.6%), and delivered one-on-one were the most popular (64.9%). Conclusion: Most women report managing their GDM with lifestyle strategies. The most common strategies reported involve approaches not currently included in the clinical practice guidelines such as reducing carbohydrate consumption. Furthermore, despite being willing to participate in lifestyle interventions, respondents report significant barriers, including lack of time and childcare commitments, whereas mentioned supports included having an online format. Lifestyle interventions for women with a history of GDM should be designed in a manner that is both tailored to the individual and considerate of existing barriers and supports to participation.

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Section: Discussionmentioning

confidence: 99%

Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey

et al. 2023

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“…This is the first study to explore postmeal walking in free-living women with GDM from their initial diagnosis to delivery. In contrast to previous research, interventions were time matched to the current standard care physical activity guidelines (3 x 10 minutes vs 30 minutes continuous) [10,18]. The proposed intervention of PMW is scalable and simple to deliver, however our findings indicate further research on mitigating sedentary behaviour and increasing steps per day in pregnancy, in addition to prescribing physical activity, is warranted.…”

Section: Discussionmentioning

confidence: 68%

“…Postmeal walking, or walking after three main meals, has been proposed as a potential strategy to target postprandial hyperglycaemia in populations with diabetes [10][11][12][13][14][15]. Postmeal walking has been shown to reduce hyperglycaemia in people with type 2 diabetes and women at risk of GDM [12,13,16,17], however the available research on women with GDM have presented varied responses [10,11,18]. Here, one bout of postprandial walking [18] or three bouts of postmeal walking [10] lowers postprandial glucose compared to sitting.…”

Section: Introductionmentioning

confidence: 99%

“…Postmeal walking has been shown to reduce hyperglycaemia in people with type 2 diabetes and women at risk of GDM [12,13,16,17], however the available research on women with GDM have presented varied responses [10,11,18]. Here, one bout of postprandial walking [18] or three bouts of postmeal walking [10] lowers postprandial glucose compared to sitting. Whereas, compared to usual care (i.e., not sitting, in a free-living non laboratory environments) three 10-min postmeal bouts were similar to 30-min of continuous walking for glycaemic control [11].…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis to Delivery: A randomised clinical trial of Postmeal Walking as a Non-Pharmacological Treatment of Gestational Diabetes

Christie

Winter

Meyer

et al. 2022

Preprint

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Objective The aim of this study was to determine whether postmeal walking is an effective and feasible alternate to standard-care advice of 30-min continuous walking for the management of gestational diabetes (GDM). Design, Setting Randomised controlled trial conducted in Australia. Sample, Methods Forty women with GDM were randomised between 28-30 weeks’ gestation into either standard-care (CTL; 30-min continuous walking) or standard care with advice for PMW (10-min walking after main meals). ActivPAL inclinometers and continuous glucose monitors (CGM) were worn from 28 weeks to 35 weeks. Birth outcomes were also collected. A linear mixed model analysed the changes from baseline (28 week) through to 35 weeks’ gestation between continuous and postmeal walking. Main Outcome Measure Postprandial glucose. Results Twenty-six women (PMW: n=12, CTL: n=14; 35  5 y) completed the intervention. 3 h postprandial glucose at lunch and dinner, were ~0.25 and ~0.35 mmol/L, respectively higher in PMW vs. CTL (group: p = 0.04). 24 h, nocturnal and fasting glucose were similar. PMW spent ~57 min/d more in sitting time and ~11 min/d less stepping time vs. CTL (group: p= 0.02 and 0.05). Both PMW and CTL had high adherence to exercise prescriptions, physical activity decreased with gestation. No difference in birth outcomes. Conclusions Postmeal walking was less effective than the standard care physical activity guidelines of thirty minutes continuous walking. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time in pregnancy are also warranted.

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“…One study to date has used continuous glucose monitoring to access overall daily blood glucose concentrations with three longer bouts of postmeal walking (PMW) in women with gestational diabetes. Andersen et al (2021) investigated three 20-minute bouts of postmeal interval walking and found improvements in mean and peak postpran-dial glucose levels in women with gestational diabetes when compared to a non-exercise control condition (Andersen et al 2021). However, the feasibility of this high-volume PMW for women with gestational diabetes is unclear with more research in free-living women with gestational diabetes warranted.…”

Section: Introductionmentioning

confidence: 99%

Three short postmeal walks as an alternate therapy to continuous walking for women with gestational diabetes

Christie

Chang

Jardine

et al. 2022

Appl. Physiol. Nutr. Metab.

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The purpose of this study was to determine whether postmeal walking (breaking up exercise into short bouts after meals) is an effective and feasible alternate to continuous walking for the management of gestational diabetes. Forty-one women with gestational diabetes were randomised between wk 28-30 gestation to either standard-care (30-min continuous exercise) or standard-care with postmeal walking (10-min of walking after breakfast, lunch and dinner). Continuous glucose and activity monitors were worn to measure glycaemic control and adherence during three-days of standard-care (baseline) followed by three-days of postmeal or continuous walking. A linear mixed model analysed the changes from baseline between postmeal and continuous walking, as an average of the three-day periods. Thirty-two women (postmeal walking n=17: control n=15, 33±5 y, body mass index 25±4 kg.m2) completed the trial. Postprandial and overnight glucose concentrations were similar between postmeal walking and control, both interventions improved from baseline. There was no difference in adherence between groups, however postmeal walking completed more minutes of prescribed physical activity across baseline and intervention days compared to the continuous walking standard-care group. Preliminary findings from this proof-of-concept study suggest postmeal walking could be a promising alternative to, and work interchangeably with, traditional advice to perform continuous moderate-intensity physical activity, in women with gestational diabetes. Novelty bullets -Three ten-minute postmeal walks may be comparable to thirty minutes continuous walking for glucose control in women with gestational diabetes - Accumulating activity in short bouts after meals is a feasible alternate to continuous exercise for women with gestational diabetes

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Postprandial interval walking—effect on blood glucose in pregnant women with gestational diabetes

Cited by 9 publications

References 38 publications

Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey

Supports and Barriers to Lifestyle Interventions in Women with Gestational Diabetes Mellitus in Australia: A National Online Survey

Diagnosis to Delivery: A randomised clinical trial of Postmeal Walking as a Non-Pharmacological Treatment of Gestational Diabetes

Three short postmeal walks as an alternate therapy to continuous walking for women with gestational diabetes

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