Anne L Harrison1, Nora Shields2, Nicholas F Taylor3, Helena C Frawley4. 1. School of Allied Health, La Trobe University; Physiotherapy Department, Werribee Mercy Hospital. 2. School of Allied Health, La Trobe University; Northern Health. 3. School of Allied Health, La Trobe University; Allied Health Clinical Research Office, Eastern Health. 4. School of Allied Health, La Trobe University; Centre for Allied Health Research and Education, Cabrini Health, Melbourne, Australia.
Abstract
QUESTION: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? DESIGN: A systematic review of randomised trials. PARTICIPANTS: Pregnant women diagnosed with gestational diabetes mellitus. INTERVENTION: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. OUTCOME MEASURES: Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. RESULTS: This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. CONCLUSION: Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. REGISTRATION: PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196].
QUESTION: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? DESIGN: A systematic review of randomised trials. PARTICIPANTS: Pregnant women diagnosed with gestational diabetes mellitus. INTERVENTION: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. OUTCOME MEASURES: Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence. RESULTS: This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise. CONCLUSION: Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus. REGISTRATION: PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196].
Authors: J Y Bernard; S Ng; P Natarajan; S L Loy; I M Aris; M T Tint; Y-S Chong; L Shek; J Chan; K M Godfrey; C M Khoo; M K-S Leow; F Müller-Riemenschneider; S-Y Chan Journal: Diabet Med Date: 2019-04-07 Impact factor: 4.359
Authors: Kaleen M Lavin; Paul M Coen; Liliana C Baptista; Margaret B Bell; Devin Drummer; Sara A Harper; Manoel E Lixandrão; Jeremy S McAdam; Samia M O'Bryan; Sofhia Ramos; Lisa M Roberts; Rick B Vega; Bret H Goodpaster; Marcas M Bamman; Thomas W Buford Journal: Compr Physiol Date: 2022-03-09 Impact factor: 8.915
Authors: Samantha F Ehrlich; Jill M Maples; Cristina S Barroso; Kathleen C Brown; David R Bassett; Nikki B Zite; Kimberly B Fortner Journal: BMC Pregnancy Childbirth Date: 2021-06-08 Impact factor: 3.007