title: Physical activity energy expenditure and glucose control in pregnant women with type 1 diabetes: is 30 minutes of daily exercise enough?
abstract: OBJECTIVE
  To describe activity patterns in pregnant women with type 1 diabetes and evaluate the impact of increased structured physical activity on glucose control.
  
  
  METHODS
  Physical activity energy expenditure (PAEE) and glucose levels (continuous glucose monitoring) were measured in 10 pregnant women with type 1 diabetes (age 33.2 years, gestation 20 weeks, BMI 27.9 kg/m(2), diabetes duration 16.6 years, HbA1c 6.5% [48 mmol/mol], insulin pump duration 2.4 years) during a day at home (free-living) and during a 24-h visit incorporating controlled diet and structured physical activity with light intensity activity (three 20-min self-paced walks) and moderate intensity activity (two 50-min sessions of brisk treadmill walking). PAEE was evaluated through individually calibrated combined heart rate and movement sensing.
  
  
  RESULTS
  Free-living PAEE was comparable to that under controlled study conditions (3.8 and 5.1 kcal/kg/day, P = 0.241), with women achieving near to the recommended 30 min of moderate physical activity (median 27 min [interquartile range 14-68]). During the free-living period, more time was spent in light activity (10.3 vs. 7.2 h, P = 0.005), with less sedentary time (13.0 vs. 14.9 h, P = 0.047) and less moderate activity (27 vs. 121 min, P = 0.022). The free-living 24-h mean glucose levels by continuous glucose monitoring were significantly higher (7.7 vs. 6.0 mmol/L, P = 0.028). The effect of controlled diet and exercise persisted overnight, with significantly less time spent hyperglycemic (19 vs. 0%, P = 0.028) and less glucose variability (glucose SD 1.3 vs. 0.7 mmol/L, P = 0.022).
  
  
  CONCLUSIONS
  A controlled diet and structured physical activity program may assist women with type 1 diabetes in achieving optimal glucose control during pregnancy.
authors: University of Cambridge Metabolic Research Laboratories, Cambridge, UK. kk426@medschl.cam.ac.uk
authors: Kavita
authors: K
authors: Kumareswaran
authors: Daniela
authors: D
authors: Elleri
authors: Janet M
authors: JM
authors: Allen
authors: Karen
authors: K
authors: Caldwell
authors: Kate
authors: K
authors: Westgate
authors: Soren
authors: S
authors: Brage
authors: Philippa
authors: P
authors: Raymond-Barker
authors: Marianna
authors: M
authors: Nodale
authors: Malgorzata E
authors: ME
authors: Wilinska
authors: Stephanie A
authors: SA
authors: Amiel
authors: Roman
authors: R
authors: Hovorka
authors: Helen R
authors: HR
authors: Murphy
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D004734:Energy Metabolism / Q000502:physiology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies
chemical_list: D001786:Blood Glucose
references: Eur J Clin Nutr. 2005 Apr;59(4):561-70
references: 15714212
references: J Appl Physiol (1985). 2007 Aug;103(2):682-92
references: 17463305
references: J Appl Physiol (1985). 2005 Sep;99(3):1205-13
references: 16103523
references: Eur J Clin Nutr. 2008 Jun;62(6):704-11
references: 17440515
references: Diabetologia. 2012 Mar;55(3):542-51
references: 22189486
references: Int J Behav Nutr Phys Act. 2011 Mar 21;8:19
references: 21418609
references: Diabetes Care. 2011 Dec;34(12):2527-9
references: 22011408
references: Am J Obstet Gynecol. 2010 Dec;203(6):556.e1-6
references: 20864072
references: Sports Med. 2010 Jun 1;40(6):493-507
references: 20524714
references: Am J Clin Nutr. 1993 Apr;57(4):494-505
references: 8460604
references: Diabetes Care. 2011 Feb;34(2):406-11
references: 21216859
references: Can J Physiol Pharmacol. 2003 Jul;81(7):696-703
references: 12897817
references: Am J Obstet Gynecol. 1987 Dec;157(6):1359-63
references: 3425644
references: Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504
references: 10993420
references: Int J Gynaecol Obstet. 2002 Apr;77(1):79-81
references: 12053898
references: Med Sci Sports Exerc. 2003 Aug;35(8):1441-6
references: 12900702
references: BMC Pregnancy Childbirth. 2010 Nov 29;10:76
references: 21114834
references: Eur J Clin Nutr. 2009 Oct;63(10):1185-91
references: 19550432
references: Diabet Med. 2012 May;29(5):558-66
references: 22313112
references: IEEE Trans Biomed Eng. 2008 Sep;55(9):2143-51
references: 18713683
references: Am J Epidemiol. 2004 Apr 1;159(7):663-70
references: 15033644
references: Med Sci Sports Exerc. 1982;14(5):377-81
references: 7154893
references: BMJ. 2008 Mar 29;336(7646):714-7
references: 18369227
references: Diabetes Metab. 2009 Nov;35(5):418-21
references: 19747869
references: Am J Obstet Gynecol. 2008 Nov;199(5):489.e1-6
references: 18667190
references: Eur J Clin Nutr. 2011 Dec;65(12):1295-301
references: 21792212
references: Am J Epidemiol. 1993 Jan 1;137(1):74-81
references: 8434575
references: Diabetes Care. 1998 Nov;21(11):1870-5
references: 9802735
references: J Appl Physiol (1985). 2004 Jan;96(1):343-51
references: 12972441