Home-Based Exercise Improves Fitness and Exercise Attitude and Intention in Women with GDM. Physical activity and gestational diabetes mellitus among Hispanic women. Effects of a Partially Home‐Based Exercise Program for Women With Gestational Diabetes Supervised home-based exercise may attenuate the decline of glucose tolerance in obese pregnant women. Effect of an Exercise Intervention on Gestational Diabetes Mellitus: A Randomized Controlled Trial Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. Effects of an aquatic physical exercise program on glycemic control and perinatal outcomes of gestational diabetes: study protocol for a randomized controlled trial Introduction of IADPSG Criteria for the Screening and Diagnosis of Gestational Diabetes Mellitus Results in Improved Pregnancy Outcomes at a Lower Cost in a Large Cohort of Pregnant Women: The St. Carlos Gestational Diabetes Study Yoga for High-Risk Pregnancy: A Randomized Controlled Trial Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Home-based exercise training improves capillary glucose profile in women with gestational diabetes. Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial Resistance exercise and glycemic control in women with gestational diabetes mellitus. Exercise in Gestational Diabetes: An Optional Therapeutic Approach? Therapeutic exercise for insulin-requiring gestational diabetics: effects on the fetus — results of a randomized prospective longitudinal study Exercise fails to improve postprandial glycemic excursion in women with gestational diabetes. Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes The effects of mindfulness eating and yoga exercise on blood sugar levels of pregnant women with gestational diabetes mellitus. Simple lifestyle recommendations and the outcomes of gestational diabetes. A 2×2 factorial randomized trial
PURPOSE The purpose of the study was to determine the effect of a home-based cycling program for women with a recent diagnosis of gestational diabetes mellitus ( GDM ) on aerobic fitness , weight gain , self-reported mobility , attitude , and intentions toward maternal exercise , and obstetric and neonatal outcomes . METHODS Forty women ( mean ± SD , 28.8 ± 0.9-wk gestation ) were r and omized to either a supervised , home-based exercise program , combining continuous steady-state and interval cycling at various intensities , in combination with unsupervised moderate intensity aerobic activity and conventional diabetic management ( EX ; n = 20 ) or to conventional management alone ( CON ; n = 20 ) . The program began following diagnosis until week 34 of pregnancy ( mean ± SD duration of training , 6 ± 1 wk ) . RESULTS Mean compliance to the training program was 96 % . Maternal aerobic fitness , and attitude and intentions toward exercise were improved in response to the home-based exercise intervention compared with CON ( P < 0.05 ) . No differences were observed between the groups with respect to maternal weight gain or obstetric and neonatal outcomes ( P > 0.05 ) . CONCLUSION A home-based exercise program of 6 ± 1 wk in duration commenced after diagnosis of GDM can improve aerobic fitness and attitude and intentions toward exercise , with no adverse effect on maternal and neonatal pregnancy outcomes OBJECTIVE Studies in predominantly non-Hispanic white population s have suggested that physical activity during pregnancy is associated with a reduced risk of gestational diabetes mellitus ( GDM ) . There are few such studies in Hispanic women , a group at increased risk for GDM . METHODS We conducted a prospect i ve cohort study of household/caregiving , occupational , sports/exercise , and active living habits and the risk of GDM among 1006 Hispanic ( predominantly Puerto Rican ) prenatal care patients in western Massachusetts from 2000 to 2004 . Prepregnancy , early pregnancy , and midpregnancy physical activity was assessed using the Kaiser Physical Activity Survey . RESULTS A total of 33 women ( 3.3 % ) were diagnosed with GDM , and 119 women ( 11.8 % ) were diagnosed with abnormal glucose tolerance . There were no significant associations between GDM risk and occupational and active living activities  in prepregnancy , early pregnancy , and midpregnancy or with a change in levels of household/caregiving , occupational , and active living activities from prepregnancy to during pregnancy . However , after controlling for age and prepregnancy body mass index ( BMI ) , women in the highest quartile of prepregnancy ( OR = 0.2 , 95 % CI 0.1 - 0.8 , p(trend ) = 0.03 ) and midpregnancy ( OR = 0.2 , 95 % CI 0.1 - 0.8 , p(trend ) = 0.004 ) household/caregiving activities  as well as midpregnancy sports/exercise ( 0.1 , 95 % CI 0.0 - 0.7 , p(trend ) = 0.12 ) had a reduced risk of GDM compared with women in the lowest quartile . CONCLUSIONS Findings in this Hispanic population , although based on small numbers of cases , are consistent with prior research among predominantly non-Hispanic white population Objective To examine the effectiveness of a partially homebased , moderate-intensity aerobic exercise program for women with gestational diabetes . Methods This was a r and omized experimental design . Thirty-three women with gestational diabetes were r and omly assigned to the exercise or the no-exercise group . Subjects underwent hemoglobin A1C assay and submaximal cycle ergometer fitness tests at baseline and at study conclusion . Subjects kept diaries of home fasting and 2-hour postpr and ial blood glucose determinations . Exercise subjects were asked to exercise for 30 minutes three to four times weekly at 70 % of estimated maximal heart rate for the weeks of study participation . Two exercise sessions weekly were supervised by the investigator , and two were unsupervised at home .  Control-group  subjects were asked to maintain their current activity level . Results Daily fasting and postpr and ial blood glucose levels , hemoglobin A1C , incidence of exogenous insulin therapy , and incidence of newborn hypoglycemia were not different between the groups . There was a training effect in the exercise group ( P = .005 ) but not in the control group ( P = .25 ) . A significant decline in daily grams of carbohydrate consumed was observed in the control group ( P = .03 ) , but not in the exercise group ( P = .97 ) . No complications were found in the subjects who exercised . Conclusions A partially home-based exercise program did not reduce blood glucose levels , but did result in a modest increase in cardiorespiratory fitness . The intervention appeared safe AIM The significant deterioration of insulin sensitivity and glucose tolerance during pregnancy can have serious health implication s for both the pregnant woman and her baby . Although it is well established that regular exercise benefits insulin sensitivity in the nonpregnant population , the effect on glucose tolerance in obese pregnant women is not known . The purpose of this study was to investigate the effect of a supervised 10-week , home-based , exercise programme , beginning at week 18 of gestation , on glucose tolerance and aerobic fitness in previously sedentary obese women . METHODS Twelve sedentary obese women were r and omized into an exercise ( EX ; n=6 ) or control ( CON ; n=6 ) group at 18 weeks of gestation . Those r and omized to EX engaged in 10 weeks of supervised home-based exercise ( three sessions a week of stationary cycling ) , while those in the CON group maintained their usual daily activity . Their glucose and insulin responses to an oral glucose tolerance test ( OGTT ) , as well as their aerobic fitness , were assessed both pre- and postintervention . RESULTS Reduced glucose tolerance in the CON , but not EX , group was indicated by a tendency postintervention towards higher blood glucose levels at 1h of the OGTT ( P=0.072 ) . Furthermore , at 2h of the postintervention OGTT , blood glucose tended to remain elevated from baseline in the CON ( P=0.077 ) . There was also a trend towards increased fitness in the EX ( P=0.064 ) , but not the CON group . CONCLUSION Regular aerobic exercise begun during pregnancy may have favourable effects on glucose tolerance and fitness in obese women , and warrants further investigation in a larger sample population OBJECTIVE : To examine the effect of an individually tailored , motivationally matched prenatal exercise intervention on gestational diabetes mellitus ( GDM ) and other measures of glucose intolerance among ethnically diverse prenatal care patients at increased risk for GDM . METHODS : The Behaviors Affecting Baby and You study r and omized eligible women at a mean ( st and ard deviation ) of 18.2 ( 4.1 ) weeks of gestation to a 12-week individually tailored , motivationally matched exercise intervention or a comparison health and wellness intervention . The goal of the exercise intervention was to achieve the American College of Obstetricians and Gynecologists ' guidelines for physical activity during pregnancy . Diagnosis of GDM , impaired glucose tolerance , abnormal glucose screen , and screening glucose values ( mg/dL ) were abstract ed from medical records . A sample size of 352 women ( 176 per group ) was planned to have 80 % power to detect reductions in risk of 35 % or larger . RESULTS : From July 2007 to December 2012 , a total of 251 ( 86.5 % ) women completed the intervention ; n=124 and 127 in the exercise and comparison interventions , respectively . Based on an intention-to-treat analysis , no statistically significant differences between the intervention groups were observed ; the relative odds of GDM in the exercise group was 0.61 ( 95 % confidence interval [ CI ] 0.28–1.32 ) as compared with the health and wellness comparison group . Odds ratios for impaired glucose tolerance and abnormal glucose screen were 0.68 ( 95 % CI 0.35–1.34 ) and 0.86 ( 95 % CI 0.51–1.47 ) , respectively . The intervention had no effect on birth outcomes . CONCLUSION : In this r and omized trial among ethnically diverse pregnant women at increased risk for GDM , we found that a prenatal exercise intervention implemented in the second trimester did not result in a statistically significant reduction in relative odds for GDM , impaired glucose tolerance , or abnormal glucose screen . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00728377 . LEVEL OF EVIDENCE : BACKGROUND We conducted a r and omized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications . METHODS We r and omly assigned women between 24 and 34 weeks ' gestation who had gestational diabetes to receive dietary advice , blood glucose monitoring , and insulin therapy as needed ( the intervention group ) or routine care . Primary outcomes included serious perinatal complications ( defined as death , shoulder dystocia , bone fracture , and nerve palsy ) , admission to the neonatal nursery , jaundice requiring phototherapy , induction of labor , cesarean birth , and maternal anxiety , depression , and health status . RESULTS The rate of serious perinatal complications was significantly lower among the infants of the 490 women in the intervention group than among the infants of the 510 women in the routine-care group ( 1 percent vs. 4 percent ; relative risk adjusted for maternal age , race or ethnic group , and parity , 0.33 ; 95 percent confidence interval , 0.14 to 0.75 ; P=0.01 ) . However , more infants of women in the intervention group were admitted to the neonatal nursery ( 71 percent vs. 61 percent ; adjusted relative risk , 1.13 ; 95 percent confidence interval , 1.03 to 1.23 ; P=0.01 ) . Women in the intervention group had a higher rate of induction of labor than the women in the routine-care group ( 39 percent vs. 29 percent ; adjusted relative risk , 1.36 ; 95 percent confidence interval , 1.15 to 1.62 ; P<0.001 ) , although the rates of cesarean delivery were similar ( 31 percent and 32 percent , respectively ; adjusted relative risk , 0.97 ; 95 percent confidence interval , 0.81 to 1.16 ; P=0.73 ) . At three months post partum , data on the women 's mood and quality of life , available for 573 women , revealed lower rates of depression and higher scores , consistent with improved health status , in the intervention group . CONCLUSIONS Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman 's health-related quality of life Background Gestational diabetes mellitus ( GDM ) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child . Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes . However , there are no r and omized controlled trials ( RCT ) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes . Methods / Design An RCT will be conducted at Instituto de Medicina Integral Prof Fern and o Figueira ( IMIP ) , Brazil . A total of 72 pregnant women will be studied ; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool , 3 times per week over 2 months . The primary endpoint will be glucose level control and use of insulin ; secondary endpoints will be the following maternal and fetal outcomes : weight gain during pregnancy , blood pressure , pre-eclampsia diagnosis , intrauterus growth restriction , preterm birth , Cesarean section , macrosomia and maternal or neonatal intensive care admission . Endpoints between intervention and control group will analyzed by t test for unpaired data and χ2 test , and the level of significance will set at < 0.05 . Discussion The physical proprieties of water make aquatic exercises ideal for pregnant women . An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance . It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control . Trial registration Clinical Trial.gov , NCT01940003 OBJECTIVE The use of the new International Association of the Diabetes and Pregnancy Study Groups criteria ( IADPSGC ) for the diagnosis of gestational diabetes mellitus ( GDM ) results in an increased prevalence of GDM . Whether their introduction improves pregnancy outcomes has yet to be established . We sought to evaluate the cost-effectiveness of one-step IADPSGC for screening and diagnosis of GDM compared with traditional two-step Carpenter-Coustan ( CC ) criteria . RESEARCH DESIGN AND METHODS GDM risk factors and pregnancy and newborn outcomes were prospect ively assessed in 1,750 pregnant women from April 2011 to March 2012 using CC and in 1,526 pregnant women from April 2012 to March 2013 using IADPSGC between 24 and 28 weeks of gestation . Both groups received the same treatment and follow-up regimes . RESULTS The use of IADPSGC result ed in an important increase in GDM rate ( 35.5 % vs. 10.6 % ) and an improvement in pregnancy outcomes , with a decrease in the rate of gestational hypertension ( 4.1 to 3.5 % : −14.6 % , P < 0.021 ) , prematurity ( 6.4 to 5.7 % : −10.9 % , P < 0.039 ) , cesarean section ( 25.4 to 19.7 % : −23.9 % , P < 0.002 ) , small for gestational age ( 7.7 to 7.1 % : −6.5 % , P < 0.042 ) , large for gestational age ( 4.6 to 3.7 % : −20 % , P < 0.004 ) , Apgar 1-min score < 7 ( 3.8 to 3.5 % : −9 % , P < 0.015 ) , and admission to neonatal intensive care unit ( 8.2 to 6.2 % : −24.4 % , P < 0.001 ) . Estimated cost savings was of € 14,358.06 per 100 women evaluated using IADPSGC versus the group diagnosed using CC . CONCLUSIONS The application of the new IADPSGC was associated with a 3.5-fold increase in GDM prevalence in our study population , as well as significant improvements in pregnancy outcomes , and was cost-effective . Our results support their adoption Background : Improvements in technology have increased the chances of survival for the micro-premature infant and the very low birth-weight infant but have significantly increased the financial burden of health care organizations . This economic burden has a significant impact on third-party payers and on society in general . Aim : The study was design ed to assess yoga therapy ( YT ) module on maternal stress level in high risk pregnancy . Subjects and Methods : In the present study , sixty-eight pregnant women ( 38 in the control group with st and ard antenatal care and 30 in the YT group ) with 27.2 ( 5.2 ) years of mean age recruited from the outpatient services of medical college and hospital in Bangalore , South India , were participated . The study was a single-blind r and omized controlled clinical trial . Perceived stress scale ( PSS ) was measured during the 12th , 20th , and 28th weeks of pregnancy . SPSS version 16.0 ( Chicago , IL , USA ) was used for all data analysis . When the data were found to be normally distributed , the RMANOVA were used to assess the PSS scores between the yoga and control groups . Significant values were set at P < 0.05 . Results : There was a significant difference in the PSS level of the YT group with significantly reduced scores at the second follow-up ( 28th week of pregnancy ) compared to the control group ( P = 0.02 ) . Women who took part in the YT module reported significantly fewer pregnancy discomforts decrease in PSS ( P = 0.02 ) than the control group where the stress level was increased ( RMANOVA test using SPSS-16 ) . Conclusion : The present study suggests that the YT module can decrease the stress level during high-risk pregnancy complications . Thus , practicing YT during high-risk pregnancy is not only a cost-effective option but also a feasible and safe option . Additional well- design ed studies are needed before a strong recommendation can be made Background Women who are diagnosed with gestational diabetes mellitus ( GDM ) are at increased risk for developing prediabetes and type 2 diabetes mellitus ( T2DM ) . To date , there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM . This paper describes the rationale , design and methodology of a 2-year , r and omized , controlled study being conducted in North Carolina . Methods / Design Using a two-group , repeated measures , experimental design , we will test a 14- week intensive intervention on the benefits of breastfeeding , underst and ing gestational diabetes and risk of progression to prediabetes and T2DM , nutrition and exercise education , coping skills training , physical activity ( Phase I ) , educational and motivational text messaging and 3 months of continued monthly contact ( Phase II ) . A total of 100 African American , non-Hispanic white , and bilingual Hispanic women between 22–36 weeks of pregnancy who are diagnosed with GDM and their infants will be r and omized to either the experimental group or the wait-listed control group . The first aim of the study is to determine the feasibility of the intervention . The second aim of study is to test the effects of the intervention on maternal outcomes from baseline ( 22–36 weeks pregnant ) to 10 months postpartum . Primary maternal outcomes will include fasting blood glucose and weight ( BMI ) from baseline to 10 months postpartum . Secondary maternal outcomes will include clinical , adiposity , health behaviors and self-efficacy outcomes from baseline to 10 months postpartum . The third aim of the study is to quantify the effects of the intervention on infant feeding and growth . Infant outcomes will include weight status and breastfeeding from birth through 10 months of age . Data analysis will include general linear mixed-effects models . Safety endpoints include adverse event reporting . Discussion Findings from this trial may lead to an effective intervention to assist women diagnosed with GDM to improve maternal glucose homeostasis and weight as well as stabilize infant growth trajectory , reducing the burden of metabolic disease across two generations . Trial registration OBJECTIVE This study examines the effects of circuit-type resistance training on the need for insulin in women with gestational diabetes mellitus . STUDY DESIGN Thirty-two patients with gestational diabetes mellitus were r and omly assigned either to a group that was treated with diet alone or to a group that was treated with diet plus resistance exercise . RESULTS The number of women whose condition required insulin therapy was the same , regardless of treatment . However , a subgroup analysis that examined only overweight women ( prepregnant body mass index , > 25 kg/m(2 ) ) showed a lower incidence of insulin use in the diet-plus-exercise group ( P<.05 ) . Women in the diet-plus-exercise group were prescribed less insulin ( P<.05 ) and showed a longer delay from diagnosis to the initiation of insulin therapy ( P<.05 ) , compared with the diet-alone group . CONCLUSION Resistance exercise training may help to avoid insulin therapy for overweight women with gestational diabetes mellitus PURPOSE Regular maternal exercise may play an important role in the management of  gestational diabetes mellitus ( GDM ) , yet specific exercise guidelines to achieve glycemic control have not been established . Furthermore , many women remain sedentary during pregnancy because of perceived barriers to exercise participation . This study examined the effectiveness of a home-based cycling program commenced upon diagnosis of GDM on daily fasting and postpr and ial blood glucose levels , glycosylated hemoglobin ( HbA1c ) , and the response of glucose and insulin to a 75-g oral glucose load . METHODS Forty sedentary women ( 28.8 ± 0.9 wk of gestation ) were r and omized to either home-based exercise training in combination with conventional management ( EX , n = 20 ) or to conventional management alone ( CON , n = 20 ) until week 34 of pregnancy . RESULTS Mean compliance to the supervised exercise training was 96 % , and no adverse effects were reported . Capillary glucose concentration was acutely reduced in response to each cycling session ( 6.3 ± 0.8 mM to 4.9 ± 0.7 mM , P < 0.001 ) . Overall , the EX group had lower mean daily postpr and ial glucose concentrations throughout the intervention compared with that in the CON group ( P < 0.05 ) despite consuming a greater proportion of dietary carbohydrate ( P < 0.05 ) . No differences were observed between groups with respect to HbA1c or the glucose and insulin response to oral glucose ingestion postintervention ( P > 0.05 ) . CONCLUSIONS A home-based cycling program may help to maintain daily postpr and ial normoglycemia in women with diet-controlled GDM We studied the impact of a training program on glucose tolerance in gestational diabetes mellitus . Women with gestational diabetes mellitus ( N = 19 ) were r and omized into either group I , a 6-week diet alone group ( 24 to 30 kcal/kg/24 hours ; 20 % protein , 40 % carbohydrate , 40 % fat ) , or group II , which followed the same diet plus exercise ( 20 minutes three times a week for 6 weeks ) . An arm ergometer was used to maintain heart rate in the training range . Glycemic response was monitored by glycosylated hemoglobin , a 50 gm oral glucose challenge with a fasting and 1-hour plasma glucose , and blood glucose self-monitoring , fasting and 1 hour  after meals .  Week 1 glycemic parameters were the same for both groups . Week 6 data ( mean + /- SD ) were as follows : group I glycosylated hemoglobin , 4.7 % + 0.2 % versus group II , 4.2 % + /- 0.2 % ; p less than 0.001 . The group I glucose challenge fasting value was 87.6 + /- 6.2 versus 70.1 + /- 6.6 mg/dl , p less than 0.001 for group II . The group I 1-hour plasma glucose challenge result was 187.5 + /- 12.9 mg/dl versus 105.9 + /- 18.9 mg/dl for group II , p less than 0.001 . The glycemic levels diverged between the groups at week 4 . We conclude that arm ergometer training is feasible in women with gestational diabetes mellitus and results in lower glycosylated hemoglobin , fasting , and 1-hour plasma glucose concentrations than diet alone . Arm ergometer training may provide a useful treatment option for women with gestational diabetes mellitus and may obviate insulin treatment BACKGROUND Type 2 diabetes mellitus is increasingly common , primarily because of increases in the prevalence of a sedentary lifestyle and obesity . Whether type 2 diabetes can be prevented by interventions that affect the lifestyles of subjects at high risk for the disease is not known . METHODS We r and omly assigned 522 middle-aged , overweight subjects ( 172 men and 350 women ; mean age , 55 years ; mean body-mass index [ weight in kilograms divided by the square of the height in meters ] , 31 ) with impaired glucose tolerance to either the intervention group or the control group . Each subject in the intervention group received individualized counseling aim ed at reducing weight , total intake of fat , and intake of saturated fat and increasing intake of fiber and physical activity . An oral glucose-tolerance test was performed annually ; the diagnosis of diabetes was confirmed by a second test . The mean duration of follow-up was 3.2 years . RESULTS The mean ( + /-SD ) amount of weight lost between base line and the end of year 1 was 4.2+/-5.1 kg in the intervention group and 0.8+/-3.7 kg in the control group ; the net loss by the end of year 2 was 3.5+/-5.5 kg in the intervention group and 0.8+/-4.4 kg in the control group ( P<0.001 for both comparisons between the groups ) . The cumulative incidence of diabetes after four years was 11 percent ( 95 percent confidence interval , 6 to 15 percent ) in the intervention group and 23 percent ( 95 percent confidence interval , 17 to 29 percent ) in the control group . During the trial , the risk of diabetes was reduced by 58 percent ( P<0.001 ) in the intervention group . The reduction in the incidence of diabetes was directly associated with changes in lifestyle . CONCLUSIONS Type 2 diabetes can be prevented by changes in the lifestyles of high-risk subjects Objective To examine the effect of regular moderate-intensity exercise ( three training sessions/week ) on the incidence of  gestational diabetes mellitus ( GDM  , primary outcome ) . We also examined if the exercise intervention modifies the association between GDM and birth weight and risk of macrosomia , gestational age , risk of caesarean delivery and maternal weight gain ( secondary outcomes ) . Methods We r and omly assigned 510 healthy gravida to either an exercise intervention or a usual care ( control ) group ( n=255 each ) . The exercise programme focused on moderate-intensity resistance and aerobic exercises ( three times/week , 50–55 min/session ) . GDM diabetes was diagnosed according to the WHO criteria and the International Association for Diabetes in Pregnancy Study Group ( IADPSG ) . Results The intervention did not reduce the risk of developing GDM ( OR 0.84 , 95 % CI 0.50 to 1.40 ) when using the WHO criteria . We observed that the intervention reduced by 58 % the GDM-related risk ( WHO criteria ) of having a newborn with macrosomia ( OR 1.76 , 95 % CI 0.04 to 78.90 vs 4.22 , 95 % CI 1.35 to 13.19 ) in exercise and control groups , respectively ) , and by 34 % the GDM-related risk of having acute and elective caesarean delivery ( OR 1.30 , 95 % CI 0.44 to 3.84 vs 1.99 , 95 % CI 0.98 to 4.06 in exercise and control groups , respectively ) . Gestational age was similar across the treatment groups ( control , exercise ) and GDM category ( GDM or non-GDM ) , and maternal weight gain was ∼12 % lower in the exercise group independent of whether women developed GDM . The results were similar when the IADPSG criteria were used instead . Conclusions Regular moderate-intensity exercise performed over the second-third trimesters of pregnancy can be used to attenuate important GDM-related adverse outcomes OBJECTIVE The objective of the study was to evaluate the effect of a resistance exercise program with an elastic b and on insulin requirement and glycemic control in patients with gestational diabetes mellitus ( GDM ) . STUDY DESIGN Sixty-four patients with gestational diabetes mellitus were r and omly assigned into 2 groups : an exercise group ( EG ; n = 32 ) and a control group not su bmi tted to the exercise program ( CG ; n = 32 ) . RESULTS A significant reduction in the number of patients who required insulin was observed in the EG ( 7/32 ) compared with the CG group ( 18/32 ) ( P = .005 ) . The percentage of time spent within the proposed target glucose range ( of at least 80 % of weekly measurements below the limits preestablished for the disease ) was significantly higher in EG compared with the CG group ( EG = 0.63 ± 0.30 ; CG = 0.41 ± 0.31 ; P = .006 ) . CONCLUSION The resistance exercise program was effective in reducing the number of patients with GDM who required insulin and in improving capillary glycemic control in this population Forty-one patients with gestational diabetes requiring insulin were enrolled in a r and omized study to investigate the efficacy of an exercise program in normalizing glucose tolerance . Seventeen of 21 patients completed the exercise program while maintaining normoglycemia and obviating  insulin therapy . Maternal and neonatal complications did not differ between the study and control groups . The type of program described appears to be safe and can serve as a model for exercise prescription for pregnant diabetic women to attain improved glucose tolerance Regular physical activity is an established therapeutic adjunct in diabetes , but has not been offered to pregnant diabetics in the past ; for sports might induce significant cardiovascular and hormonal changes that are able to reduce blood flow to the uterus and thus limit oxygen transfer to the fetus . Study ing the impact of a medically supervised exercise program on gestational diabetes mellitus [ GDM ) in a r and omised prospect i ve longitudinal study , this paper aims to assess the effects of maternal moderate and strenuous exercise on the fetus . By evaluating shortterm fetal responses as reflected in heart rate patterns ( FHR ) and longterm-pregnancy complications and neonatal outcome , our results suggest that -- in absence of ominous FHR changes or significant changes in uterine activity following the exercise sessions or increased diabetes-related peri- and neonatal morbidity --  regular physical activity seems to be a safe therapeutic option for the fetus of GDM mothers The effect of an acute period of moderate intensity exercise on maternal glycemic excursion following a mixed nutrient meal was studied . Five normal ( NL ) and six gestational diabetic ( GDM ) subjects were enrolled . A r and omized crossover design was used to compare fasting glucose and insulin levels , peak glucose and insulin levels and incremental area of the glycemic and insulin curves following a mixed nutrient meal with or without an exercise stress that took place 14 h earlier . Exercise consisted of upright stationary cycling for 30 min at a heart rate consistent with 60 % VO2max . The clinical characteristics of normal and gestational diabetic subjects were comparable . Mean values ( + /-SEM ) with , versus without , exercise for fasting glucose ( NL : 78.9 + /- 2.6 vs. 80.0 + /- 2.6 mg/dl ; GDM : 86.4 + /- 2.0 vs. 82.1 + /- 3.5 mg/ dl ) , peak glucose ( NL : 132.3 + /- 10.4 vs. 139.1 + /- 15.6 mg/dl ; GDM : 165.8 + /- 5.5 vs. 160.3 + /- 7.8 mg/dl ) , the area under the glycemic curve ( NL : 5758 + /- 1038 vs. 6393 + /- 1281 mg/dl.min ; GDM : 8,178 + /- 890 vs. 8,331 + /- 563 mg/dl.min ) did not differ . Similarly , plasma insulin levels did not differ between protocol s for either group of subjects . Exercise has been proposed as a treatment to reduce glycemia in gestational diabetes . Results from this study indicate a single bout of exercise did not blunt the glycemic response observed following a mixed nutrient meal Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain ( GWG ) from gestational diabetes ( GDM ) diagnosis to delivery , overall and stratified by prepregnancy overweight/obesity . Methods Prospect i ve cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic health records ( n = 1055 ) .  Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine ’s ( IOM ) prepregnancy BMI -specific recommended ranges for weekly rate of GWG in the second and third trimesters . Results In the full cohort , any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [ odds ratio ( 95 % confidence interval ) : 0.63 ( 0.40 , 0.99 ) ] , with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise . Upon stratification by prepregnancy overweight/obesity , significant associations were only observed for BMI ≥ 25.0 kg/m2 : any vigorous intensity exercise , as compared to none , was associated with 54 % decreased odds of excess GWG [ 0.46 ( 0.27 , 0.79 ) ] and significant trends were detected for decreasing odds of GWG both below and above the IOM ’s recommended ranges with increasing level of vigorous exercise ( both P ≤ 0.03 ) . No associations were observed for moderate intensity exercise . Conclusions for Practice In women with GDM , particularly overweight and obese women  , vigorous intensity exercise during pregnancy may reduce the odds of excess GWG AIM This r and omized controlled trial was carried out to investigate the effect of mindfulness eating and yoga exercise on blood sugar levels among pregnant Thai women with GDM . BACKGROUND Interventions promoting achievement of good glycemic control result in desired pregnancy outcomes . Little is known about the health benefits of mindfulness eating and yoga exercise on blood sugar levels among pregnant with GDM . METHODS A r and omized controlled trial was carried out . Main outcome measures were capillary fasting plasma glucose , 2-h postpr and ial blood glucose , and hemoglobin A1c . RESULTS The intervention group showed significantly reduced fasting plasma glucose , 2-h postpr and ial blood glucose , and glycosylated hemoglobin ( HbA1c ) in the intervention group ( p<0.05 ) . CONCLUSIONS Mindfulness eating and yoga exercise had health benefits on glycemic control in pregnant women with GDM . It should be recommended in clinical and community health services The benefits of exercise and behavioural recommendations in gestational diabetes mellitus ( GDM ) are controversial . In a r and omized trial with a 2 × 2 factorial design , we examined the effect of exercise and behavioural recommendations on metabolic variables , and maternal/neonatal outcomes in 200 GDM patients . All women were given the same diet : group D received dietary recommendations only ; group E was advised to briskly walk 20‐min/day ; group B received behavioural dietary recommendations ; group BE was prescribed the same as B + E.  Dietary habits improved in all groups . In a multivariable regression model , fasting glucose did not change . Exercise , but not behavioural recommendations , was associated with the reduction of postpr and ial glucose ( p < 0001 ) , glycated haemoglobin ( HbA1c ; p < 0.001 ) , triglycerides ( p = 0.02 ) and C‐reactive protein ( CRP ; p < 0.001 ) and reduced any maternal/neonatal complications ( OR = 0.50 ; 95%CI=0.28–0.89;p = 0.02 ) . In GDM patients  a simple exercise programme reduced maternal postpr and ial glucose , HbA1c , CRP , triglycerides and any maternal/neonatal complications , but not fasting glucose values
BACKGROUND Gestational diabetes mellitus ( GDM ) is associated with both short- and long-term complications for the mother and her baby .
Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes .The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes .
Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes ( this review ) Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes OBJECTIVES : To evaluate the effects of exercise interventions for improving maternal and fetal outcomes in women with GDM .