Studies have shown that physical inactivity can lead to health problems like coronary heart disease, type 2 diabetes, breast and colon cancers, and shortened life expectancy. Pregnancy is a time when many women are less active than usual.
During the early weeks of pregnancy, carbohydrate metabolism is affected by the rise in hormones estrogen and progesterone. This rise stimulates the growth of beta cells in the pancreas leading to increased insulin production. As pregnancy progresses, the pancreatic cells continue to grow, and there is an increased insulin response to glucose or food. Moreover, other physiological changes like in body weight, hormonal balance, vascular system, and metabolism happen during pregnancy.
The overall effect of these changes can lead to gestational diabetes mellitus (GDM). There is too much sugar in the blood during pregnancy, but it normalizes after pregnancy. GDM can cause problems for the mother, like pre-eclampsia, and the baby, like macrosomia (born much bigger than average), jaundice, and birth trauma. Children of mothers who had GDM are more likely to be obese or have glucose intolerance and type 2 diabetes later in life.
Physical activity can help reduce the increased insulin resistance common during pregnancy. A study found that glycemic control was improved in women with GDM treated with an exercise program, similar to the improvements obtained with pharmacological therapies. However, most of these trials studied the effects of a short-term exercise program; more should be conducted with extended periods of exercise programs.
Some studies have shown that daily exercise or physical activity has effectively prevented type 2 diabetes in high-risk adults. Since the underlying mechanisms for type 2 diabetes mellitus in non-pregnant women are similar for GDM, it is likely that increasing your daily physical activity or participating in an aerobic exercise program during pregnancy may help prevent GDM.
This study was participated in by 40 women who have been pregnant more than once and are in their 24th week of gestation with risk for GDM due to obesity, with a body mass index of at least 30 kilograms per meter square. All are physically active and with at least one of the following characteristics: history of macrosomia, abnormal glucose tolerance during a previous pregnancy, and first-grade relative with type 2 diabetes mellitus.
They were randomly selected and allocated equally into two groups. Intervention group (A) followed an aerobic exercise program in the form of walking on an uninclined treadmill, three times weekly, 45 minutes for each session, until the end of 37 weeks of gestation in addition to diet control. This program was under the supervision of a trained physiotherapist. Control group (B) received the same diet control given to Group A. The women in both groups were assessed of their fasting blood glucose and insulin levels before and after the treatment program. The intervention period was from 24th to 37th weeks of pregnancy.
There is a highly significant decrease in fasting blood glucose and insulin levels in both groups, but it was more remarkable in group A.
Moderate-intensity aerobic exercise effectively reduces fasting blood glucose and insulin levels in pregnant women at high risk for GDM. However, diet control and traditional care were also effective, as shown in the control group, but to a lesser extent than aerobic exercises.
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