Background: Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, no meta-analysis has analyzed the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effects of weekly supervised exercise (EXE) or physical activity counseling (PA) in women with GDM compared with usual prenatal care (UPN) on glycemic control.
Methods: Eligible trials were identified from Medline, EMBASE, Web of Science, Scopus and SportDiscus up to December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly supervised (at least once a week) prenatal exercise or PA counseling for which FBG values before and after intervention were available. Random-effects meta-analysis was performed for mean difference in FBG after exercise intervention.
Results: The search yielded 781 publications, of which 82 were assessed for eligibility and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P = 0.11) compared with UPN. However, PA versus UPN showed a significant reduction in absolute FBG concentrations (weighted mean difference -3.88 mg/dL; 95% confidence interval -7.33, -0.42 mg/dL; I 2 48%; P heterogeneity < 0.15).
Conclusions: Physical activity counseling in women with GDM showed a significant effect compared with UPN on FBG concentrations, possibly due to a longer follow-up time compared with the EXE groups. This result highlights the importance of an early intervention that lasts to delivery for best practice of GDM management.
Keywords: exercise; glycemic control; hyperglycemia; insulin resistance; pregnancy; 妊娠; 胰岛素抵抗; 血糖控制; 运动; 高血糖.
© 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.