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The Impact of Structured Aerobic and Resistance Exercise on the Course and Outcome of Gestational Diabetes Mellitus

Gestational diabetes mellitus is defined as any carbohydrate intolerance first diagnosed during pregnancy (Metzger et al, 2007). It is associated with a variety of adverse outcomes, both for the mother and fetus. The objective of this thesis was to examine the effects of structured programme consisting of aerobic and resistance exercises on the course and outcomes of gestational diabetes mellitus. Aim of research was to investigate how this exercise programme affects parameters of glycaemic control, rate of complications in pregnancy and during labour and delivery, weight gain and fat mass gain in pregnancy, and newborn's parameters. Thirty-eight pregnant women were randomly assigned into two groups: experimental group treated with exercise therapy and medical nutritional therapy (EG ; N = 18) and control group (CG ; N = 20) treated with medical nutritional therapy alone. Structured exercise programme was performed from the diagnosis till the end of pregnancy two times per week for the duration of 50-55 minutes. Furthermore, pregnant women in EG performed at least 30 minutes of vigorous walk once per day. A total of 365 exercise sessions were performed during the trial, with 20, 28 ± 7, 68 sessions on average per subject and adherence to protocol was 84, 22%. There were no adverse side effects caused by the exercise programme. Results showed significant difference in the postprandial glucose levels at the end of pregnancy (P ˂ 0, 001). There were no significant differences between groups in fasting glucose level at the end of pregnancy, rate of complications in pregnancy and during labour and delivery, body weight, body fat percentage and weight gain during specific time points of pregnancy, neonatal Apgar scores, neonatal body mass and ponderal index. There was a significant difference in neonatal body mass index which was a little higher in experimental group (P = 0, 035). Our results clearly confirm positive effect of exercise on postprandial glucose levels at the end of pregnancy. Also, exercise proved to be perfectly safe as an adjunctive therapy for GDM. Therapeutic exercise during pregnancy might be an effective and safe method for treatment of GDM, along with other lifestyle measures.

pregnancy ; therapeutic exercise ; training ; physical activity ; glycaemic control

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