Pre‐gravid physical activity and reduced risk of glucose intolerance in pregnancy: the role of insulin sensitivity

Abstract

Objective-Pre-gravid physical activity has been associated with a reduced risk of gestational diabetes mellitus (GDM), although neither the types of exercise nor the physiologic mechanisms underlying this protective effect have been well studied. Thus, we sought to study the relationships between types of pre-gravid physical activity and metabolic parameters in pregnancy, including glucose tolerance, insulin sensitivity and beta-cell function.Design/Patients/Measurements-851 women underwent a glucose challenge test (GCT) and a 3-hr oral glucose tolerance test (OGTT) in late pregnancy, yielding 4 glucose tolerance groups: (i) GDM; (ii) gestational impaired glucose tolerance (GIGT); (iii) abnormal GCT with normal glucose tolerance on OGTT (abnormal GCT NGT); and (iv) normal GCT with NGT on OGTT (normal GCT NGT). Pre-gravid physical activity was assessed using the Baecke questionnaire, which measures (i) total physical activity and (ii) its 3 component domains: work, non-sport leisure-time, and vigorous/sports activity.Results-Glucose tolerance status improved across increasing quartiles of pre-gravid total physical activity (p=0.0244). Whereas neither work nor non-sport leisure-time activity differed between glucose tolerance groups, pre-gravid vigorous/sports activity was significantly higher in women with normal GCT NGT compared to women with (i) abnormal GCT NGT (p=0.0018), (ii) GIGT (p=0.0025), and (iii) GDM (p=0.0044). In particular, vigorous/sports activity correlated with insulin sensitivity (measured by IS OGTT ) (r=0.21,p<0.0001). Furthermore, on multiple linear regression analysis, pre-gravid vigorous/sports activity emerged as a significant independent predictor of IS OGTT in pregnancy (t=4.97,p<0.0001). CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptConclusions-Pre-gravid vigorous/sports activity is associated with a reduced risk of glucose intolerance in pregnancy, an effect likely mediated by enhanced insulin sensitivity.

Cardiometabolic Implications of Postpartum Weight Changes in the First Year After Delivery

“…Pregravid physical activity in the year before pregnancy was assessed using the Baecke questionnaire, an established instrument that has been extensively validated in several populations, including women of childbearing age (12,13). This questionnaire was completed during the OGTT (i.e., prior to knowing their gestational glucose tolerance status) (14,15). The Baecke questionnaire measures total physical activity and its three component domains: occupation-associated activity (work index), sport-related physical activity (sport index), and nonsport leisure-time activity (leisure-time index).…”

Exercise Guidelines for Women with Gestational Diabetes

“…Dempsey et al reported that women who participated in any physical activity during the year before getting pregnant experienced a 56% risk reduction in GDM compared with inactive women, but those who engaged in physical activity during both time periods experienced a 69% reduced risk (Dempsey et al, 2004b). It has also been shown that pre-gravid physical activity (vigorous activity) was associated with a reduced risk of IGT in pregnancy, an effect likely mediated by enhanced insulin sensitivity (Retnakaran et al, 2009). Similar results were found when investigating the effect of physical activity during pregnancy.…”

A terhességi cukorbetegség rövid története, kockázati tényezői és diagnosztikája napjainkban

“…Az inzulinszenzitivitás fokozá-sával és a glükóztolerancia javításával, számos mechanizmuson keresztül, a fizikai aktivitásnak jótékony hatása van az inzulinrezisztencia több aspektusára [35]. Két vizsgálat a terhesség előtti és alatti fizikai aktivitás és GDM kockázatcsökkenése között pozitív összefüggést igazolt [36,37]. Ez a hatás fokozódik a fizikai aktivitás intenzitásának és idejének növelésével.…”