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Benefits of Exercise for Women with Gestational Diabetes


What is Gestational Diabetes?[edit]

Gestational diabetes (GD) is impaired glucose tolerance that occurs in women during pregnancy. GD affects between 2-14% of pregnant women (one third of cases go undiagnosed) [1] [2] [3] [4] [5] [6] and is the most common metabolic complication of pregnancy [2] [5]. GD generally resolves after the pregnancy has ended however approximately 50% of women who have had GD will develop type 2 diabetes within 5 years of their GD diagnosis [1] [7].

Risk Factors for Developing GD[edit]

While there are several theories as to what causes GD the strongest scientific link to the cause of GD is a mother’s weight status before and during pregnancy [8] [4]. High BMI prior to pregnancy (>25) [8] and excessive weight gain during pregnancy increases the risk of developing GD [4]. Other risk factors include family history of diabetes, previous delivery of a large baby, diet and lifestyle factors (inactivity and poor diet), smoking, some medications, women of short stature, older age of mother (35+), amount and timeframe of previous pregnancies (short periods between pregnancies), ethnicity (Women of Asian, African and Hispanic decent have and increased risk of developing GD) [7] [9] [2] [5] [4].

Maternal Complications from GD[edit]

Complications to the mother from GD are similar to other forms of diabetes that include: 50% chance of developing type 2 diabetes 5 years post pregnancy [10] [9], miscarriage, caesarean section (due to large baby), preterm delivery, hypertension, preeclampsia (Pregnancy induced hypertension and fluid retention), hypoglycaemia (Low blood glucose), postpartum maternal haemorrhage, increased risk of maternal infection postpartum, increased risk of thrombosis (blood clot) postpartum, stillbirth [1] [11] [5].

Fetal Complications from GD[edit]

Complications of GD to the fetus include: birth injuries due to large birth weight (particularly shoulder dystocia), fetal distress, macrosomia (abnormally large birthweight), stillbirth, post-birth the baby is at risk of developing hypoglycaemia (low blood sugar effects up to 30% of infants), hypothermia, hypocalcaemia and transient cardiomyopathy, increased risk of childhood obesity, memory deficits in childhood, low birthweight (due to vascular disease associated with diabetes), glucose intolerance, increase chance of developing diabetes later in life [10] [5] [9] [11].

Exercise Recommendations During Pregnancy[edit]

To reduce the risk of adverse effects from GD it is important to effectively manage the disease through exercise [1]. Prior to undertaking any exercise program it is essential to be screened by your doctor [6]. Exercise should not be undertaken if you are unwell, have an infection, your blood glucose is below 6mmol/L or above 10mmol/L [7] or are experiencing symptoms of weakness, dizziness, sweating or fainting [5]. During exercise it is important to:

  • Have a carbohydrate rich snack with you at all times
  • Drink plenty of fluids before, during and after exercise
  • Carry medical ID tags
  • Wear good shoes and clean socks to prevent injury and infection
  • Avoid jarring and strenuous exercises
  • Avoid activity where head is facing downwards

[7] [6]

Moderate intensity exercise should be undertaken in 20-60min bouts 4-7 days per week. Some of the exercise can include:

  • Low-resistance strength exercise with high repetitions
  • Swimming
  • Brisk walking
  • Tai chi
  • Some flexibility exercises like yoga 2 times per week

[5] [7]

You can also ensure exercise is part of your daily routine by undertaking household activity in 10 minute bouts 3 times a day like:

  • Vacuuming
  • Sweeping
  • Mopping
  • Gardening
  • Carrying groceries

[12] [2] [5]


Further Reading/Information Sources[edit]

  • Diabetes Australia – Gestational Diabetes

http://www.diabetesaustralia.com.au/living-with-diabetes/gestational-diabetes/

  • Diabetes Australia – Gestational Diabetes Keeping Active

http://www.diabetesaustralia.com.au/en/Living-with-Diabetes/Gestational-Diabetes/Managing-Gestational-Diabetes/Keeping-Active/

  • Exercise in Pregnancy

http://www.pregnancy.com.au/resources/topics-of-interest/pregnancy/exercise-in-pregnancy.shtml

  • Health Insite – Exercise and Pregnancy

http://www.healthinsite.gov.au/topics/Exercise_and_Pregnancy


References[edit]

  1. a b c d Mulholland, C, Njoroge, T, Mersereau, P & Williams, J 2007,’Comparision Guidelines Available in the United States for Diagnosis and Management of Diabetes before, during, and after Pregnancy’, Journal of Women’s Health, vol. 16, no. 6, pp. 790-801.
  2. a b c d Chasan-Taber, L, Schmidt, MD, Pekow, P, Sternfeld, B, Mason, JE, Solomon, CG, Braun, B & Markenson, G 2008, ‘Physical Activity and Gestational Diabetes Mellitus among Hispanic Women’, Journal of Women’s Health, vol. 17, no. 6, pp. 999-1008.
  3. Doran, F 2008, ‘Gestational Diabetes Mellitus: Perspectives on Lifestyle Changes during Pregnancy and Post-partum, Physical Activity and the Prevention of Future Type 2 Diabetes’, Australian Journal of Primary Health, vol. 14, no. 3, pp. 85-92.
  4. a b c d Morisset, A, Tchernof, A, Dube, M, Veillette, J, Weisnagel, SJ & Robitaille, J 2011, ‘Weight Gain Measures in Women with Gestational Diabetes Mellitus’, Journal of Women’s Health, vol. 20, no. 3, pp. 375-380.
  5. a b c d e f g h Dunning, T 2009, Care of People with Diabetes: A Manual of Nursing Practice, 3rd edn, Wiley-Blackwell, United Kingdom, pp. 3, 11-12, 399-407
  6. a b c Woolf-May, K 2006, Exercise Prescription Physiological Foundations: A guide for Health, Sport and Exercise Professionals, Churchill Livingstone, Philadelphia, pp. 59-71.
  7. a b c d e Durstine, JL & Moore, GE 2003, ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities, 2nd edn, American College of Sports Medicine, United States of America, pp. 133-142.
  8. a b Villamor, E & Cnattingius, S 2006, ‘Interpregnancy Weight Change and Risk of Adverse Pregnancy Outcomes: A Population Based Study’, Lancet, vol. 368, pp. 1164-1170.
  9. a b c Rosenberg, TJ, Garbers, S, Lipkind, H & Chiasson, MA 2005, ‘Maternal Obesity and Diabetes Risk Factors for Adverse Pregnancy Outcomes: Differences Among 4 Racial/Ethnic Groups’, American Journal of Public Health, vol. 95, no. 9, pp. 1545-1551.
  10. a b Chasan-Taber, L, Marcus, BH, Stanek, E, Ciccolo, JT, Marquez, DX, Solomon, CG & Markenson, G 2009, ‘A Randomized Controlled Trail of Prenatal Physical Activity to Prevent Gestational Diabetes: Design & Methods’, Journal of Women’s Health, vol. 18, no. 6, pp. 851-859.
  11. a b Ray, JG, Vermeulen, MJ, Shapiro, JL & Kenshole, AB 2001,’Maternal and Neonatal Outcomes in Pregestational and Gestational Diabetes Mellitus, and the Influence of Maternal Obesity and Weight Gain: the DEPOSIT study’, Q J Med, vol. 94, pp. 347-356.
  12. Schmidt, MD, Pekow, P, Freedson, PS, Markenson, G & Chasan-Taber, L 2006, ‘Physical Activity Patterns During Pregnancy in a Diverse Population of Women’, Journal of Women’s Health, vol. 15, no. 8, pp. 909-918.