Postprandial walking reduces glucose levels in women with gestational diabetes mellitus

Coe, Dawn P.; Conger, Scott A.; Kendrick, Jo M.; Howard, Bobby; Thompson, Dixie L.; Bassett, David R.; White, Jennifer Duffield

doi:10.1139/apnm-2017-0494

Cited by 28 publications

(32 citation statements)

References 17 publications

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“…Our study extends these to raise the possibility that increasing leisure-time PA prior to 24 weeks gestation (when GDM screening occurs) even at levels that fall short of recommendations, may be beneficial. This finding is consistent with evidence that increased activity is associated with lower glucose levels in women with GDM [ 12 , 31 ]. Future work is needed to relate activity patterns to glucose, other biomarkers and weight gain to better understand mechanisms that may explain our findings.…”

Section: Discussionsupporting

confidence: 92%

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes

Catov

Parker

Gibbs

et al. 2018

Int J Behav Nutr Phys Act

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BackgroundAlthough leisure-time physical activity (PA) contributes to overall health, including pregnancy health, patterns across pregnancy have not been related to birth outcomes. We hypothesized that women with sustained low leisure-time PA would have excess risk of adverse pregnancy outcomes, and that changing patterns across pregnancy (high to low and low to high) may also be related to risk of adverse pregnancy outcomes.MethodsNulliparous women (n = 10,038) were enrolled at 8 centers early in pregnancy (mean gestational age in weeks [SD] = 12.05 [1.51]. Frequency, duration, and intensity (metabolic equivalents) of up to three leisure activities reported in the first, second and third trimesters were analyzed. Growth mixture modeling was used to identify leisure-time PA patterns across pregnancy. Adverse pregnancy outcomes (preterm birth, [PTB, overall and spontaneous], hypertensive disorders of pregnancy [HDP], gestational diabetes [GDM] and small-for-gestational-age births [SGA]) were assessed via chart abstraction.ResultsFive patterns of leisure-time PA across pregnancy were identified: High (35%), low (18%), late decreasing (24%), early decreasing (10%), and early increasing (13%). Women with sustained low leisure-time PA were younger and more likely to be black or Hispanic, obese, or to have smoked prior to pregnancy. Women with low vs. high leisure-time PA patterns had higher rates of PTB (10.4 vs. 7.5), HDP (13.9 vs. 11.4), and GDM (5.7 vs. 3.1, all p < 0.05). After adjusting for maternal factors (age, race/ethnicity, BMI and smoking), the risk of GDM (Odds ratio 2.00 [95% CI 1.47, 2.73]) remained higher in women with low compared to high patterns. Early and late decreasing leisure-time PA patterns were also associated with higher rates of GDM. In contrast, women with early increasing patterns had rates of GDM similar to the group with high leisure-time PA (3.8% vs. 3.1%, adjusted OR 1.16 [0.81, 1.68]). Adjusted risk of overall PTB (1.31 [1.05, 1.63]) was higher in the low pattern group, but spontaneous PTB, HDP and SGA were not associated with leisure-time PA patterns.ConclusionsSustained low leisure-time PA across pregnancy is associated with excess risk of GDM and overall PTB compared to high patterns in nulliparous women. Women with increased leisure-time PA early in pregnancy had low rates of GDM that were similar to women with high patterns, raising the possibility that early pregnancy increases in activity may be associated with improved pregnancy health.Trial registrationRegistration number NCT02231398.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0701-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 92%

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes

Catov

Parker

Gibbs

et al. 2018

Int J Behav Nutr Phys Act

View full text Add to dashboard Cite

show abstract

“…Although studies evaluating glycemic impact of exercise in GDM are sparse, exercise has been shown to improve fasting and postprandial glycemia in GDM. 55 Acute bouts of moderate-intensity walking after eating improved postprandial glucose control for up to 3 hours after the meal, 56 and postmeal walking is frequently recommended when there are no contraindications to physical activity. 54…”

Section: Treatment Lifestyle Interventionsmentioning

confidence: 99%

Gestational Diabetes Mellitus

Szmuilowicz

Josefson

Metzger

2019

Endocrinology and Metabolism Clinics of North America

248

163

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“…If the woman plans to exercise, appropriate reductions in insulin levels based on the characteristics of exercise (duration and intensity) should be made. Glucose should be monitored before the start of the exercise session; adequate caloric supplementation is important to minimize the hypoglycemia risk before, during and after exercise [107] depending on the insulin analogs utilized [108]. Additionally, postprandial walking (up to 2 h after the meal) can be beneficial in reducing post-prandial glucose levels [108].…”

Section: Avoiding Exercise-induced Hypoglycemia In Insulin Treated Womenmentioning

confidence: 99%

Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus

et al. 2021

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Gestational Diabetes Mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. Regular exercise is important for a healthy pregnancy and can lower the risk of developing GDM. For women with GDM, exercise is safe and can affect the pregnancy outcomes beneficially. A single exercise bout increases skeletal muscle glucose uptake, minimizing hyperglycemia. Regular exercise training promotes mitochondrial biogenesis, improves oxidative capacity, enhances insulin sensitivity and vascular function, and reduces systemic inflammation. Exercise may also aid in lowering the insulin dose in insulin-treated pregnant women. Despite these benefits, women with GDM are usually inactive or have poor participation in exercise training. Attractive individualized exercise programs that will increase adherence and result in optimal maternal and offspring benefits are needed. However, as women with GDM have a unique physiology, more attention is required during exercise prescription. This review (i) summarizes the cardiovascular and metabolic adaptations due to pregnancy and outlines the mechanisms through which exercise can improve glycemic control and overall health in insulin resistance states, (ii) presents the pathophysiological alterations induced by GDM that affect exercise responses, and (iii) highlights cardinal points of an exercise program for women with GDM.

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Postprandial walking reduces glucose levels in women with gestational diabetes mellitus

Cited by 28 publications

References 17 publications

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes

Gestational Diabetes Mellitus

Exercise as a Therapeutic Intervention in Gestational Diabetes Mellitus

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