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      Exercise and its role in gestational diabetes mellitus

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          Abstract

          Gestational diabetes mellitus (GDM) refers to diabetes diagnosed in the second or third trimester of pregnancy that is not clearly either type 1 or type 2 diabetes. GDM is a common medical complication in pregnancy that has been rapidly increasing worldwide. GDM is associated with both short- and long-term health issues for both mothers and offspring. Consistent with type 2 diabetes, peripheral insulin resistance contributes to the hyperglycemia associated with GDM. Accordingly, it is important to identify strategies to reduce the insulin resistance associated with GDM. To date, observational studies have shown that exercise can be a non-invasive therapeutic option for preventing and managing GDM that can be readily applied to the antenatal population. However, the relevant mechanisms for these outcomes are yet to be fully elucidated. The present review aimed to explain the potential mechanisms of exercise from the perspective of reducing the insulin resistance, which is the root cause of GDM. Exercise recommendations and opinions of exercise during pregnancy are briefly summarized.

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          Most cited references47

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          Gestational diabetes mellitus.

          (2004)
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            Signaling pathways in insulin action: molecular targets of insulin resistance.

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              Physical Activity Before and During Pregnancy and Risk of Gestational Diabetes Mellitus

              OBJECTIVE Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with a substantially elevated risk of adverse health outcomes for both mothers and offspring. Physical activity may contribute to the prevention of GDM and thus is crucial for dissecting the vicious circle involving GDM, childhood obesity, and adulthood obesity, and diabetes. Therefore, we aimed to systematically review and synthesize the current evidence on the relation between physical activity and the development of GDM. RESEARCH DESIGN AND METHODS Medline, EMBASE, and Cochrane Reviews were searched from inception to 31 March 2010. Studies assessing the relationship between physical activity and subsequent development of GDM were included. Characteristics including study design, country, GDM diagnostic criteria, ascertainment of physical activity, timing of exposure (prepregnancy or early pregnancy), adjusted relative risks, CIs, and statistical methods were extracted independently by two reviewers. RESULTS Our search identified seven prepregnancy and five early pregnancy studies, including five prospective cohorts, two retrospective case-control studies, and two cross-sectional study designs. Prepregnancy physical activity was assessed in 34,929 total participants, which included 2,813 cases of GDM, giving a pooled odds ratio (OR) of 0.45 (95% CI 0.28–0.75) when the highest versus lowest categories were compared. Exercise in early pregnancy was assessed in 4,401 total participants, which included 361 cases of GDM, and was also significantly protective (0.76 [95% CI 0.70–0.83]). CONCLUSIONS Higher levels of physical activity before pregnancy or in early pregnancy are associated with a significantly lower risk of developing GDM.
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                Author and article information

                Contributors
                Journal
                Chronic Dis Transl Med
                Chronic Dis Transl Med
                Chronic Diseases and Translational Medicine
                KeAi Publishing
                2095-882X
                2589-0514
                20 December 2016
                December 2016
                20 December 2016
                : 2
                : 4
                : 208-214
                Affiliations
                [a ]Department of Obstetrics and Gynecology of Peking University First Hospital, Beijing 100034, China
                [b ]Exercise Physiology and Biochemistry, The University of Western Australia, Perth, Western Australia 6009, Australia
                Author notes
                []Corresponding author. yanghuixia@ 123456bjmu.edu.cn
                Article
                S2095-882X(16)30119-0
                10.1016/j.cdtm.2016.11.006
                5643755
                29063044
                49d956ff-842b-4566-b551-b9f8eb40e8d8
                © 2016 Chinese Medical Association. Production and hosting by Elsevier B.V. on behalf of KeAi Communications Co., Ltd.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 15 January 2016
                Categories
                Perspective

                exercise,gestational diabetes mellitus,insulin resistance,pregnancy

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