title: Simple lifestyle recommendations and the outcomes of gestational diabetes. A 2 × 2 factorial randomized trial.
abstract: The benefits of exercise and behavioural recommendations in gestational diabetes mellitus (GDM) are controversial. In a randomized trial with a 2 × 2 factorial design, we examined the effect of exercise and behavioural recommendations on metabolic variables, and maternal/neonatal outcomes in 200 GDM patients. All women were given the same diet: group D received dietary recommendations only; group E was advised to briskly walk 20-min/day; group B received behavioural dietary recommendations; group BE was prescribed the same as B + E. Dietary habits improved in all groups. In a multivariable regression model, fasting glucose did not change. Exercise, but not behavioural recommendations, was associated with the reduction of postprandial glucose (p < 0001), glycated haemoglobin (HbA1c; p < 0.001), triglycerides (p = 0.02) and C-reactive protein (CRP; p < 0.001) and reduced any maternal/neonatal complications (OR = 0.50; 95%CI=0.28-0.89;p = 0.02). In GDM patients a simple exercise programme reduced maternal postprandial glucose, HbA1c, CRP, triglycerides and any maternal/neonatal complications, but not fasting glucose values.
authors.affiliation: Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bo
authors.forename: R
authors.initials: R
authors.lastname: Rosato
authors.forename: G
authors.initials: G
authors.lastname: Ciccone
authors.forename: S
authors.initials: S
authors.lastname: Canil
authors.forename: R
authors.initials: R
authors.lastname: Gambino
authors.forename: C B
authors.initials: CB
authors.lastname: Poala
authors.forename: F
authors.initials: F
authors.lastname: Leone
authors.forename: A
authors.initials: A
authors.lastname: Valla
authors.forename: G
authors.initials: G
authors.lastname: Grassi
authors.forename: E
authors.initials: E
authors.lastname: Ghigo
authors.forename: M
authors.initials: M
authors.lastname: Cassader
authors.forename: G
authors.initials: G
authors.lastname: Menato
mesh_terms: D001724:Birth Weight; D016640:Diabetes, Gestational / Q000517:prevention & control*; D004032:Diet; D037001:Directive Counseling; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011247:Pregnancy
keywords: behavioural recommendations; exercise; gestational diabetes mellitus