Dietary and exercise interventions and glycemic control and maternal and newborn outcomes in women diagnosed with gestational diabetes: Systematic review

Allehdan, Sabika; Basha, Asma; Asali, Fida; Tayyem, Reema

doi:10.1016/j.dsx.2019.07.040

Cited by 28 publications

(25 citation statements)

References 55 publications

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“…This was also reflected in the general population with 43e50% of people reducing their physical activity levels during the restrictions [25,26]. Physical activity, along with dietary intervention, can lower fasting and postprandial glucose levels in women with GDM [27]. This highlights the importance of additional support for pregnant women with diabetes during future pandemics to keep physically active.…”

Section: Discussionmentioning

confidence: 92%

The Impact of COVID-19 on diet and lifestyle behaviours for pregnant women with diabetes

Amataiti

Hood

Krebs

et al. 2021

Clinical Nutrition ESPEN

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Background/aims: A self-reported online survey was performed to investigate the immediate effect of COVID-19 lockdown restrictions in New Zealand on dietary intake, and lifestyle behaviours among pregnant women with diabetes. Participants/methods: The survey was sent to 82 pregnant women who had Type 1, Type 2 Diabetes, or Gestational Diabetes and attended the Diabetes in Pregnancy Clinic in Wellington, New Zealand in May 2020, while the most restrictive COVID-19 lockdown measures were in place. All women received standard pregnancy nutrition advice provided by a dietitian, were monitoring blood glucose levels with nursing support, and seeing specialist endocrinologists and obstetricians for their pregnancy care. Results: Fifty women (61%) responded to the survey. There was no evidence of differences in dietary intake during the restrictions, compared to before, for most food items. During the restriction's women consumed more bread (Odds Ratio (95% CI): 0.39 (0.18e0.83) p ¼ 0.02); less battered fish: 3.11 (1.20 e8.05) p ¼ 0.02; and less hot chips/fries: 6.32 (2.67e14.93) p < 0.0001. During the restriction's women consumed more meals at home: 0.05 (0.14e0.15) p < 0.0001; less takeaways: 3.63 (1.54e7.34) p ¼ 0.003; and less restaurant and caf e meals: 15.05 (6.03e37.59) p < 0.0001, when the services reopened. Conclusions: The nutrition of pregnant women with diabetes was not compromised during a brief COVID-19 lockdown restriction. This finding is reassuring, with countries worldwide adopting brief intermittent lockdown periods to restrict the spread of the COVID-19 virus.

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Section: Discussionmentioning

confidence: 92%

The Impact of COVID-19 on diet and lifestyle behaviours for pregnant women with diabetes

Amataiti

Hood

Krebs

et al. 2021

Clinical Nutrition ESPEN

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“…Research appears unanimous concerning the increased efficacy of combined diet and exercise interventions for the treatment of GDM and for improving pregnancy outcomes [ 3 , 42 , 82 , 83 ]. Nevertheless, it appears that a GDM diagnosis alone does not motivate women to increase their PA levels [ 84 , 85 ].…”

Section: Discussionmentioning

confidence: 99%

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

et al. 2021

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Medical nutrition therapy is an integral part of gestational diabetes mellitus (GDM) management; however, the prescription of optimal energy intake is often a difficult task due to the limited available evidence. The present pilot, feasibility, parallel, open-label and non-randomized study aimed to evaluate the effect of a very low energy diet (VLED, 1600 kcal/day), or a low energy diet (LED, 1800 kcal/day), with or without personalized exercise sessions, among women with GDM in singleton pregnancies. A total of 43 women were allocated to one of four interventions at GDM diagnosis: (1) VLED (n = 15), (2) VLED + exercise (n = 4), (3) LED (n = 16) or (4) LED + exercise (n = 8). Primary outcomes were gestational weight gain (GWG), infant birth weight, complications at delivery and a composite outcomes score. Secondary outcomes included type of delivery, prematurity, small- for-gestational-age (SGA) or large-for-gestational-age (LGA) infants, macrosomia, Apgar score, insulin use, depression, respiratory quotient (RQ), resting metabolic rate (RMR) and middle-upper arm circumference (MUAC). GWG differed between intervention groups (LED median: 12.0 kg; VLED: 5.9 kg). No differences were noted in the type of delivery, infant birth weight, composite score, prevalence of prematurity, depression, RQ, Apgar score, MUAC, or insulin use among the four groups. Regarding components of the composite score, most infants (88.4%) were appropriate-for-gestational age (AGA) and born at a gestational age of 37–42 weeks (95.3%). With respect to the mothers, 9.3% experienced complications at delivery, with the majority being allocated at the VLED + exercise arm (p < 0.03). The composite score was low (range 0–2.5) for all mother-infant pairs, indicating a “risk-free” pregnancy outcome. The results indicate that adherence to a LED or VLED induces similar maternal, infant and obstetrics outcomes.

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“…This result is in concurrent with El Toony et al [23] who stated that, the blood glucose level significantly controlled by medical nutritional therapy and exercise in their study about the effectiveness of an educational program for women with GDM. Another study by Allehdan et al [24] who studied the effect of dietary and exercise interventions on glycemic control, maternal and neonatal outcomes in women with GDM reported that, the combination of diet and exercise interventions controls fasting & postprandial blood glucose level.…”

Section: Discussionmentioning

confidence: 99%

Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes

Elbeltagy

Khedr

Abd-Ella

2020

CNS

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Background: Gestational Diabetes Mellitus (GDM) is one of the most common medical health problems that may happen during pregnancy and may lead to a range of short and long-term maternal, fetal as well as neonatal complications. However, effective management and education on GDM self-care measures improve pregnancy outcomes for both women and their neonates.Aim: The study was carried out to evaluate the effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes.Methods: A quasi-experimental research design was used at Antenatal Clinic of Obstetric and Gynecological Specialty Center at Mansoura University Hospitals, Mansoura city. A purposive sample of 126 pregnant women diagnosed with GDM, assigned to the intervention group (n = 63) who utilized the Gestational Diabetes Mellitus Guideline (GDMG) of care in addition to routine antenatal care and control group (n = 63) who followed routine antenatal care only. Tools: Three tools were used to collect data from participants as A structured interview schedule, maternal assessment record and fetal & neonatal assessment record.Results: The current study findings indicated that, there was a highly statistical significant reduction of body mass index and the mean random blood glucose levels at 34 & 37 weeks’ of pregnancy after intervention in the GDMG group than control groups (p < .001). Also, there was a statistical significant reduction in the occurrence of maternal complications as gestational hypertension, preeclampsia, preterm labor and polyhydramnios in the GDMG group .Similarly, the neonates of the GDMG group had better Apgar scores after birth & lower incidence for developing neonatal complications as prematurity, respiratory distress syndrome and NICU admission.Conclusions and Recommendations: This study showed that, pregnant women with GDM who utilized the GDMG had better maternal & neonatal outcomes than those who did not utilize it. It is recommended to provide a manual GDMG to all pregnant women with GDM for better lifestyle changes & maintaining self-management regimen as well as better pregnancy outcomes.

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Dietary and exercise interventions and glycemic control and maternal and newborn outcomes in women diagnosed with gestational diabetes: Systematic review

Cited by 28 publications

References 55 publications

The Impact of COVID-19 on diet and lifestyle behaviours for pregnant women with diabetes

The Impact of COVID-19 on diet and lifestyle behaviours for pregnant women with diabetes

TIMER: A Clinical Study of Energy Restriction in Women with Gestational Diabetes Mellitus

Effect of utilizing developed gestational diabetes mellitus guideline on pregnancy and childbirth outcomes

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