Gestational diabetes is when blood sugar levels are higher than the normal values during pregnancy, and occurs when the body cannot produce enough insulin (i.e. the hormone that helps control blood sugar levels) [1]. Around 700,000 women give birth in England and Wales each year, and it is estimated that around 5% of these women are affected by gestational diabetes. It is a condition that can cause substantial complications and long-term adverse health issues to the mother and to the infant. Once the mother has given birth, the condition usually disappears, and the blood sugar levels restore back to pre-pregnancy levels. However, women who develop gestational diabetes during pregnancy have a greater risk of developing type 2 diabetes later on in life, which is difficult to reverse.
According to the scientific research, one effective strategy for treating/managing gestational diabetes, or even possibly prevent developing gestational diabetes is by engaging in regular physical activity.
The current evidence of the body's responses to a single bout of exercise
There is evidence that after a single bout of exercise, your body will show improvements in insulin sensitivity in the muscles for around 2-72 hours following the exercise bout. In other words, exercise can increase how sensitive the body is to the effects of insulin. Therefore, the increase in insulin sensitivity will result in improved uptake of glucose from cells, which mean less glucose is circulating in the blood and therefore will decrease the blood glucose content.
The effects of regular physical activity on gestational diabetes
So, there is evidence that after just one bout of exercise, the body can improve the way it manages its glucose levels. Studies also found that engaging in regular physical activity before and during the early stages of pregnancy can reduce the risk of gestational diabetes by around 51% and 48%, respectively [3]. The later stages of pregnancy might be more difficult to be physically active due to problems such as severe fatigue or back pain. As well, being physically active in the later stage (third trimester) is not as important compared to the earlier stages (first and second trimester) as the body has already adapted to the bodily changes that comes with pregnancy in the early stages.
Engaging in a low-intensity exercise session lasting between 20-45 minutes, at least 3 times a week, can lead to the body having better control over glucose and insulin levels in the blood, as well as it having a positive effect on your cardio fitness [4].
Don't forget that nutrition is important
Although exercise has been reported to have many positive effects on regulating GDM, it is important that pregnant women are aware of the importance on nutritional intake and water intake. More specifically, it is important to be aware of the changes in nutritional demands when participating in an exercise regime. Adequate nutritional intake is also important in women with gestational diabetes to maintain safe blood glucose levels and reduce the risk of ketonaemia (when there is abnormally high levels of ketones in the blood).
Staying hydrates is also very important, and pregnant women should consume adequate amount of water to replace the fluids lost during exercise. Dehydration can have an adverse effect on blood glucose levels, and if an individual with gestational diabetes does not stay hydrates, it can lead to further dehydration and blood glucose could continue to increase.
Therefore, regular physical activity in pregnant women is an effective way of managing gestational diabetes. However, it is important that pregnant women are aware of the changes in the demands for nutritional and water intake when following an exercise regime.
Specific considerations for exercise in pregnancy
Pregnant women who want to begin an exercise regime should be encouraged to see a professional, to ensure that they follow exercise plans that are appropriate not only for their ability, but also for their phase of pregnancy, as well as it being safe for themselves and for the infant. If at any point a pregnant woman experiences vaginal bleeding, chest pain, dizziness, muscle weakness and uterine contractions, then they must stop exercising immediately and get advice from an expert. Due to physical changes a woman goes through during pregnancy, it is important that exercise programmes are monitored regularly and adjusted when the mother shows signs of discomfort or adverse symptoms.
To conclude
Engaging in regular physical activity of low-moderate intensity, 3 days a week, for a duration of 20-45 minutes per session, can contribute towards lowering the risk of developing gestational diabetes, as well as an effective strategy for managing the condition. Also, it is more effective if implemented prior, and in the early stages of pregnancy.
References:
NHS. (2016). Gestational diabetes. Retrieved 22 February 2019, from https://www.nhs.uk/conditions/gestational-diabetes/
Crowther, C. A., Hiller, J. E., Moss, J. R., McPhee, A. J., Jeffries, W. S., & Robinson, J. S. (2005). Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. New England Journal of Medicine, 352(24), 2477-2486.
Dempsey, J. C., Butler, C. L., Sorensen, T. K., Lee, I. M., Thompson, M. L., & Miller, R. S. et al. (2004). A case-control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Research & Clinical Practice, 66(2), 203-215.
Ceysens, G., Rouiller, D., & Boulvain, M. (2006). Exercise for diabetic pregnant women. Cochrane Database of Systematic Reviews, (3).
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