engleski

The role of physical activity and therapeutic exercise in the treatment of gestational diabetes mellitus

Introduction. Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance of various degrees first manifested during pregnancy, and is related to a significant risk of adverse pregnancy outcomes and complications during and after birth, as well as long-term health risks. The primary goal of treatment is to optimize glycaemic control and improve pregnancy outcomes. As part of treatment, exercise is recommended for pregnant women without contraindications. Aim. To summarize results of trials on the effects of exercise on GDM and to assess the possible efficacy of this approach in the treatment of GDM. Methods. Four databases were systematically reviewed along with reference lists of relevant articles up to August 2016. Included studies were prospective randomized and non randomized controlled trials which investigated effects of therapeutic exercise on the course and outcomes of GDM. Results. Nine trials have been found, 7 randomized and 2 non randomized which included a total of 544 pregnant women. Main outcomes measured included complications during pregnancy and birth, and glycemic control parameters. The type, frequency, intensity and duration of exercise programmes varied. Most trials reported significant difference in glycaemic control or the need for insulin therapy in favour of exercise group. Discussion and Conclusion. A definite clinical significance of exercise as additional therapy for GDM still cannot be established with certainty. More randomized controlled trials are necessary in order to determine the optimal exercise programme. Therapeutic exercise during pregnancy might be an effective method for improving course and outcomes of GDM.

pregnancy ; gestational diabetes mellitus ; exercise ; physical activity

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