Aim: To investigate if exercise improves postprandial glycaemic control in women diagnosed with gestational diabetes mellitus.
Design: A systematic review with meta-analysis of randomised, controlled trials.
Method: Participants were pregnant women diagnosed with gestational diabetes mellitus where the intervention was exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Outcome measures included postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence.
Results: Eight randomised, controlled trials (588 participants) were included; seven of these trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to usual care, significantly improved postprandial glycaemic control (MD –0.33 mmol/L, 95% CI –0.49 to –0.17) and lowered fasting blood glucose (MD –0.31 mmol/L, 95% CI –0.56 to –0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30 minutes, three to four times per week. All studies reported that complications or other adverse events were either similar or reduced with exercise.
Conclusion: Adding exercise to usual care of gestational diabetes mellitus, safely helps to control postprandial blood glucose levels and other measures of glycaemic control and may assist in reducing maternal and neonatal complications in gestational diabetes mellitus.