Effects of Moderate-Intensity Aerobic Exercise on Blood Glucose Levels and Pregnancy Outcomes in Patients With Gestational Diabetes Mellitus: A Randomized Controlled Trial

Diabetes Therapy - Tập 12 - Trang 2585-2598 - 2021
Xie Yaping1, Zhao Huifen2, Zhao Meijing3, Huang Huibin4, Liu Chunhong5, Huang Fengfeng2, Wu Jingjing3
1Nursing Department, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
2Clinical Nursing Teaching and Research Department, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
3Gynaecology and Obstetrics Department, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
4Endocrinology Department, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
5Outpatient Department, Second Affiliated Hospital of Fujian Medical University, Quanzhou, China

Tóm tắt

To investigate the effects of structured moderate-intensity aerobic exercise on blood glucose, insulin, and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). One hundred one patients with GDM were randomly divided into a control group (50 cases) and an experimental group (51 cases) in a class 3 first-level general hospital. GDM patients in the control group received a personalized diabetes diet intervention, online education, and routine prenatal care. The experimental group added 6 weeks of moderate-intensity aerobic exercise in addition to the identical conditions given to the control group. The differences of fasting and 2-h postprandial blood glucose, insulin use, and adverse pregnancy outcomes were evaluated between the experimental and control group after intervention. Outcomes were available from 89 participants. Compared with before intervention, there were statistically significant differences in fasting blood glucose and 2-h blood glucose after three meals in both groups (P < 0.05). There were statistically significant differences in the average fasting blood glucose, the average 2-h postprandial blood glucose, the insulin dosage, and the utilization rate between the experimental and control group after the intervention (P < 0.05). Parameters in the experimental group were all lower than in the control group. Compared with the control group, the incidence of adverse pregnancy outcomes in the experimental group after intervention was not statistically significant (P > 0.05). Moderate-intensity aerobic exercise can help improve blood glucose control and insulin use in patients with GDM. In the future, long-term follow-up can be conducted for maternal and neonatal infants to evaluate the impact of exercise intervention on the risk of type 2 diabetes. The trial was approved by the registration of the Chinese Clinical Trial Registry. Registration number: ChiCTR1900027929.

Tài liệu tham khảo

American College of Obstetricians and Gynecologists. Practice bulletin no. 180 summary: gestational diabetes mellitus [J]. Obstet Gynecol. 2017;130(1):244.

Sklempe Kokic I, Ivanisevic M, Biolo G, et al. Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial[J]. Women Birth. 2018;31(4):e232–8.

Laine MK, Kautiainen H, Gissler M, et al. Gestational diabetes in primiparous women-impact of age and adiposity: a register-based cohort study[J]. Acta Obstet Gynecol Scand. 2018;97(2):187–94.

Zhu Y, Zhang C. Prevalence of gestational diabetes and risk of progression to type 2 diabetes: a global perspective[J]. Curr Diab Rep. 2016;16(1):7.

American Diabetes Association. Management of diabetes in pregnancy: standards of medical care in diabetes-2018 [J]. Diabetes Care. 2018;41((Suppy 1)):S137–43.

Zhu M, Cai J, Liu S, et al. Relationship between gestational fasting plasma glucose and neonatal birth weight, prenatal blood pressure and dystocia in pregnant Chinese women [J]. Diabetes Metab Res. 2014;30(6):489–96.

Mottola MF, Artal R. Role of exercise in reducing gestational diabetes mellitus[J]. Clin Obstet Gynecol. 2016;59(3):620–8.

Chiefari E, Arcidiacono B, Foti D, et al. Gestational diabetes mellitus: an updated overview[J]. J Endocrinol Invest. 2017;40(9):1–11.

Damm P, Houshmand-Oeregaard A, Kelstrup L, et al. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark[J]. Diabetologia. 2016;59(7):1396–9.

Aroda VR, Christophi CA, Edelstein SL, et al. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the diabetes prevention program outcomes study 10-year follow-up [J]. J Clin Endocr Metab. 2015;100(4):1646–53.

Yu Y, Xie R, Shen C, et al. Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis [J]. J Matern Fetal Neonatal Med. 2018;31(12):1632–7.

Ming WK, Ding W, Zhang C, et al. The effect of exercise during pregnancy on gestational diabetes mellitus in normal-weight women: a systematic review and meta-analysis[J]. BMC Preg Childb. 2018;18(1):440–8.

Xing S, Gu Z, Jiang X. Research progress of exercise and exercise in patients with hematopoietic stem cell transplantation [J]. Chin J Nurs. 2018;53(2):242–7.

Savikj M, Zierath JR. Train like an athlete: applying exercise interventions to manage type 2 diabetes[J]. Diabetologia. 2020;63(8):1491–9.

Schwaab B, Kafsack F, Markmann E, et al. Effects of aerobic and anaerobic exercise on glucose tolerance in patients with coronary heart disease and type 2 diabetes mellitus [J]. Cardiovasc Endocrinol Metab. 2020;9(1):3–8.

Schwaab B, Windmoller M, Konig IR, et al. Evaluation of aerobic exercise intensity in patients with coronary artery disease and type 2 diabetes mellitus [J]. J Clin Med. 2020;9(9):2773.

Cooper D, Yang L. Pregnancy And Exercise [M]. Stat Pearls Publishing; 2021. p. 35–43.

Artal R, Catanzaro RB, Gavard JA, et al. A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus[J]. Appl Physiol Nutr Metab. 2007;32(3):596–601.

Avery MD, Leon AS, Kopher RA. Effects of a partially home-based exercise program for women with gestational diabetes [J]. Obstet Gynecol. 1997;89(1):10–5.

Bo S, Rosato R, Ciccone G, et al. Simple lifestyle recommendations and the outcomes of gestational diabetes. A 2 × 2 factorial randomized trial [J]. Diabetes Obes Metab. 2014;16(10):1032–5.

Bung P, Artal R, Khodiguian N, et al. Exercise in gestational diabetes. An optional therapeutic approach? [J]. Diabetes. 1991;40(Suppl 2):182.

Davenport MH, Mottola MF, Mcmanus R, et al. A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study [J]. Appl Physiol Nutr Metab. 2008;33(3):511–7.

Halse RE, Wallman KE, Dimmock JA, et al. Home-based exercise improves fitness and exercise attitude and intention in women with GDM [J]. Med Sci Sports Exerc. 2015;47(8):1698–704.

Jovanovic PL, Durak EP, Peterson CM. Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes [J]. Am J Obstet Gynecol. 1989;161(2):415–9.

Mottola MF, Davenport MH, Ruchat SM, et al. 2019 Canadian guideline for physical activity throughout pregnancy[J]. Br J Sports Med. 2018;52(21):1339–46.

Royal College of Obstetricians and Gynaecologists. Exercise in pregnancy [EB/OL]. http://www.Rcog.org.uk/womens-health/clinical-guidance/exercise-pregnancy, 2014-06-20/2019-12-01.

Yang H, Xu X, Wang Z, et al. Guidelines for the diagnosis and treatment of gestational diabetes mellitus (2014) [J]. Diabetes World (Clin). 2014;8(11):489–98.

Brankston GN, Mitchell BF, Ryan EA, et al. Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus[J]. Am J Obstet Gynecol. 2004;190(1):188–93.

Mao L, Zhao M, Wang J, et al. Effect of resistance training combined with aerobic training on low back pain during pregnancy [J]. Chin Rehab Theory Pract. 2016;22(07):848–51.

Borg GA. Psychophysical bases of perceived exertion[J]. Med Sci Sports Exerc. 1982;14(5):377–81.

De Barros MC, Lopes MA, Francisco RP, et al. Resistance exercise and glycemic control in women with gestational diabetes mellitus[J]. Am J Obstet Gynecol. 2010;203(6):556.e1-556.e6.

Garber CE, Blissmer B, Deschenes MR, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults[J]. Med Sci Sports Exerc. 2011;43(7):1334–59.

Bgeginski R, Ribeiro PAB, Mottola MF, et al. Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: a systematic review and meta-analysis of randomized trials [J]. J Diabetes. 2017;9(11):1023–32.

Chen L, Yang Z. Meta-analysis of the effect of exercise intervention in gestational diabetes mellitus [C]. Chinese Association of Sports Science. The 11th National Sports Science Conference. Nanjing, Jiangsu Province, 2019:2.

Cuff DJ, Meneilly GS, Martin A, et al. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes [J]. Diabetes Care. 2003;26(11):2977–82.

Wang C, Guelfi KJ, Yang HX. Exercise and its role in gestational diabetes mellitus[J]. Chronic Dis Transl Med. 2016;2(4):208–14.

Church TS, Blair SN, Cocreham S, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial [J]. JAMA. 2010;305(09):892.

Harrison A. Critically appraised papers: an aerobic and resistance exercise program can improve glycaemic control in women with gestational diabetes mellitus [commentary] [J]. J Physiother. 2018;64(2):124.

Huang X, Huang J, Wu J, et al. Different exercises for pregnant women with gestational diabetes: a meta-analysis of randomized controlled trials [J]. J Sports Med Phys Fit. 2020;60(3):464–71.

Davenport MH, McCurdy AP, Mottola MF, et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis[J]. Br J Sports Med. 2018;52(21):1376–85.

Davenport MH, Ruchat SM, Poitras VJ, et al. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis[J]. Br J Sports Med. 2018;52(21):1367–75.

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Diabetes Therapy

Tập 12

2585-2598

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