Resistance exercise and glycemic control in women with gestational diabetes mellitus

Barros, Marcelo Costa de; Lopes, Marco Antônio Borges; Francisco, Rossana Pulcineli Vieira; Sapienza, Andréia David; Zugaib, Marcelo

doi:10.1016/j.ajog.2010.07.015

Cited by 121 publications

(182 citation statements)

References 15 publications

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“…In human studies, maternal exercise effects have focused mainly on pregnancies complicated by gestational diabetes. In a study of women with gestational diabetes, it was found that resistance exercise was effective in lowering the number of women who needed insulin therapy to maintain normal blood glucose levels (9). In a study of healthy pregnant women, mild physical activity was found to lower the risk of developing gestational diabetes (26).…”

Section: Discussionmentioning

confidence: 99%

Perinatal exercise improves glucose homeostasis in adult offspring

Carter

Lewis

Wilkerson

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

138

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Emerging research has shown that subtle factors during pregnancy and gestation can influence long-term health in offspring. In an attempt to be proactive, we set out to explore whether a nonpharmacological intervention, perinatal exercise, might improve offspring health. Female mice were separated into sedentary or exercise cohorts, with the exercise cohort having voluntary access to a running wheel prior to mating and during pregnancy and nursing. Offspring were weaned, and analyses were performed on the mature offspring that did not have access to running wheels during any portion of their lives. Perinatal exercise caused improved glucose disposal following an oral glucose challenge in both female and male adult offspring (P Ͻ 0.05 for both). Blood glucose concentrations were reduced to lower values in response to an intraperitoneal insulin tolerance test for both female and male adult offspring of parents with access to running wheels (P Ͻ 0.05 and P Ͻ 0.01, respectively). Male offspring from exercised dams showed increased percent lean mass and decreased fat mass percent compared with male offspring from sedentary dams (P Ͻ 0.01 for both), but these parameters were unchanged in female offspring. These data suggest that short-term maternal voluntary exercise prior to and during healthy pregnancy and nursing can enhance long-term glucose homeostasis in offspring.running; pregnancy; programming; mice IN 2007, 23.5 MILLION PEOPLE in the US were estimated to have diabetes, and this number is increasing (4). Interestingly, and what is often underappreciated, is that the metabolic status of an individual is decided not only by their inherited genes, nutritional intake, and physical exercise but also by maternal nutrition and obesity during pregnancy. In 1992, Hales and Barker (18) put forth the thrifty phenotype hypothesis that suggested that malnourished pregnant mothers produce smaller offspring that have a higher incidence of obesity, diabetes, and heart disease in adulthood. This hypothesis has since been modified to the developmental origins of health and disease (DOHaD) (15,17,18).The DOHaD suggests that the maternal environment and fetal programming lead to a higher incidence of several diseases later in life (14, 16). A growing number of studies have been designed to provide evidence for the negative impact of DOHaD, using mice, rats, and sheep as animal models (11,12,31,38). Many of these studies are directed at malnutrition through protein restriction or physical stressors that produce similar effects (8,11,34,44,45), but more recent studies are elucidating the metabolic effects of high-fat diet consumption during pregnancy on offspring (22,38,44,48).It has been known since Hippocrates and Galen that physical activity is an important component of a healthy lifestyle (33). However, knowledge about the contributions of maternal exercise during pregnancy and the long-term consequences on offspring is minimal. In both rats and mice, maternal exercise during pregnancy can improve brain physiology and cognition...

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Section: Discussionmentioning

confidence: 99%

Perinatal exercise improves glucose homeostasis in adult offspring

Carter

Lewis

Wilkerson

et al. 2012

American Journal of Physiology-Endocrinology and Metabolism

138

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“…Destes, 313 foram excluídos após a revisão dos títulos, resumos e palavras-chave, além da utilização dos critérios de inclusão e exclusão, restando 10 estudos que foram lidos na íntegra pelos dois pesquisadores. Foram incluídos seis estudos [19][20][21][22][23][24] na análise qualitativa final (Figura 1).…”

Section: Resultsunclassified

“…Em relação ao efeito do treinamento de força no controle glicêmico (Tabela 2), apenas dois estudos 23,24 foram encontraram e relataram que a exigência de insulina foi menor no grupo intervenção, comparada ao grupo controle, tabela 2 -Efeitos do treinamento de força no controle glicêmico e necessidade de insulina em gestantes com DMG. 18 .…”

Section: Resultsunclassified

Treinamento aeróbico e de força no tratamento do diabetes gestacional: uma revisão sistemática

Portella

Bgeginski

Kruel

2014

Rev Bras Ativ Fis Saude

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ResumoO diabetes mellitus gestacional (DMG) é uma complicação comum cuja prevalência tem crescido constantemente. Evidências sugerem que intervenções em gestantes com DMG podem reduzir a ocorrência de desfechos adversos. Apesar de o exercício físico ser bem aceito como uma terapia complementar no manejo do diabetes tipo 2 fora da gestação, no DMG ainda não se sabe qual a melhor prescrição para obter os melhores resultados. Portanto, este estudo teve como objetivo revisar as evidências científicas sobre o efeito de diferentes tipos de treinamento físico no tratamento do DMG. Foram consultadas as bases de dados, Scopus, Pubmed e Scielo. Foram excluídos os estudos de revisão sistemática, editoriais, cartas ao editor, relatos de caso, estudos laboratoriais e artigos que não avaliassem dos efeitos de intervenção através de exercício aeróbico ou de força, em mulheres diagnosticadas com DMG. Foram identificados 661 estudos e incluídos 6 na análise final. Foram encontrados estudos que utilizaram o treinamento físico como parte do tratamento do DMG, a maioria demonstrou efeito benéfico, como melhora do controle glicêmico e diminuição das necessidades de insulina. O tipo de exercício escolhido pela maioria dos pesquisadores foi o aeróbico, entretanto os estudos que utilizaram o exercício de força também demonstraram melhor controle glicêmico. Considerando os achados desses estudos, o treinamento físico tanto aeróbico como de força, apresentou efeitos benéficos para mulheres com DMG, uma vez que ajudou a controlar a glicemia e reduzir as necessidades de insulina. PalavRas-chaveGestação; Resistência à insulina; Exercício. abstRact The gestational diabetes mellitus (GDM) is a common complication whose prevalence has steadily grown. Evidence suggests that interventions in pregnant women with GDM may reduce the occurrence of adverse outcomes. Although exercise is well accepted as a complementary therapy in type 2 diabetes in non-pregnant women, but is still unclear what is the best prescription for best results in

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“…Recent studies have focused on the impact of exercise training on daily capillary blood glucose concentrations in GDM patients, with encouraging results [50][51][52]. This is an important outcome as several studies have found that controlling capillary glucose concentrations reduces the risk of fetal overgrowth; a major complication of GDM [53].…”

Section: Can Exercise Play a Role In The Management Of Gdm?mentioning

confidence: 99%

“…Two other studies, both employing resistance exercises, have also demonstrated improvements in glycemic control [50,52]. de Barros et al recently published the results of a trial involving 64 patients diagnosed with GDM between 24 and 34 weeks gestation.…”

Section: Diet Plus Insulinmentioning

confidence: 99%

The Role of Exercise in Reducing the Risks of Gestational Diabetes Mellitus

Hopkins

Artal

2013

Womens Health (Lond Engl)

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Women's Health (2013) 9(6), [569][570][571][572][573][574][575][576][577][578][579][580][581] support the demands of fetal growth. A progressive and marked insulin resistance develops in maternal skeletal muscle, beginning around mid-pregnancy and progressing during the third trimester to levels that approximate the insulin resistance seen in T2DM [9]. Hormones and adipo kines secreted from the placenta, including TNF-a, placental lactogen, placental growth hormone, cortisol and progesterone, are probable triggers of insulin resistance in pregnancy, owing to rapid reversal at delivery [10].Normal pregnancy is characterized by increased insulin secretion from pancreatic b cells to compensate for peripheral insulin resistance. This can be displayed as a hyperbolic relationship between insulin sensitivity (the inverse of insulin resistance) and insulin secretion from pancreatic b cells (Figure 2). The development of GDM occurs when a mother does not secrete enough insulin in order to be able to meet the metabolic stress of peripheral insulin resistance. The reciprocal relation ship is preserved in most GDM women, but occurs at much lower level of insulin secretion. That is, women with GDM secrete 40-70% less insulin for any degree of insulin resistance [11,12]. Therefore, pregnancy-induced insulin resistance may unmask the b-cell dysfunction characteristic of GDM [13].Serial assessments of insulin sensitivity starting before pregnancy have also demonstrated slightly greater insulin resistance persisting into the third trimester in women with GDM compared with normal pregnant women [11]. This resistance applies to both the action of insulin Gestational diabetes mellitus & maternal obesityGestational diabetes mellitus (GDM) is the most common medical complication of pregnancy and is defined as glucose intolerance or high blood glucose concentrations (hyperglycemia), with onset or first recognition during pregnancy. The prevalence of GDM varies from 1 to 20% and is rising worldwide in line with increasing trends of maternal obesity and Type 2 diabetes mellitus (T2DM) [1,2]. The incidence of GDM rises disproportionately with increasing obesity. A recent meta-analysis of 20 population-based studies estimated that the risk of developing GDM is 2.14-fold higher for overweight (BMI: 25.0-29.9), 3.56-fold higher for obese (BMI: ≥30.0) and 8.56-fold higher for severely obese women (BMI: ≥40.0) compared with normal weight pregnant women (BMI: <25.0) [3]. Obesity and GDM have been recognized as independent risk factors for a number of adverse maternal and fetal outcomes, including diabetes, hypertension, operative deliveries, macrosomia and neonatal complications [4][5][6]. More recently, we have begun to understand that maternal obesity and GDM are also associated with significant lifelong consequences for the next generation [7,8]. As obesity and GDM share many of the same health consequences, obese women and their offspring are at a greater risk for adverse outcomes (Figure 1). Pathophysiology of GDMDuring normal pregnancy,...

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Resistance exercise and glycemic control in women with gestational diabetes mellitus

Cited by 121 publications

References 15 publications

Perinatal exercise improves glucose homeostasis in adult offspring

Perinatal exercise improves glucose homeostasis in adult offspring

Treinamento aeróbico e de força no tratamento do diabetes gestacional: uma revisão sistemática

The Role of Exercise in Reducing the Risks of Gestational Diabetes Mellitus

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