4. Discussion
GDM, reduced fasting blood glucose
GDM
Lifestyle interventions are considered front-line therapy for helping normalize blood glucose values in individuals diagnosed with GDM. However, the optimal timing of the exercise (pre- versus post-prandial) has not been established. We applied a randomized cross-over study design evaluating the effects of five days of postprandial walks (10 min immediately after breakfast, lunch, and dinner), and a single 30-min walk at any point following the first hour after a meal on 1 and 2 h postprandial and 24 h glucose outcomes in women with, and without GDM. Overall, there were no differences between the two exercise interventions regarding blood glucose control in pregnant individuals with or without GDM.A systematic review and meta-analysis evaluating randomized controlled trials comparing exercise with no exercise in individuals with GDM (Davenport et al., 2018) found that chronic exercise was associated with reduced fasting blood glucose (standardized mean difference (SMD) −0.59, 95% CI −1.07 to −0.11; 4 RCTs, moderate effect size, 363 women) and postprandial blood glucose concentration (SMD −0.85, 95% CI −1.15 to −0.55; 3 RCTs, large effect size, 344 women) compared to the control group [The first study to compare three 10 min postprandial walks to 30 min continuous moderate intensity walking at any time in individuals with GDM found that the walking had no impact on 3 h postprandial glucose values [Regarding dietary intake, as a front-line therapy for managing GDM, dietary intake is important in controlling blood glucose values. As such, GDM patients often receive dietary counselling and are advised to consume foods with lower glycemic indices and control their caloric intake [The high level of compliance to the intervention was reflected in the results of the physical activity enjoyment scale, which indicate that, within each group, neither the three 10 min walks nor the 30 min walk were more enjoyable. Given that walking is a feasible, accessible, and low-cost activity and that physical activity is important in glycemic control, enjoyment can be equally attained regardless of the approach in terms of duration or timing around a meal [