Regular Exercise to Prevent the Recurrence of Gestational Diabetes Mellitus: A Randomized Controlled Trial.
OBJECTIVE
To investigate the effect of a supervised home-based exercise program on the recurrence and severity of gestational diabetes mellitus (GDM) together with other aspects of maternal health and obstetric and neonatal outcomes.


METHODS
This randomized controlled trial allocated women with a history of GDM to an exercise intervention (14-week supervised home-based stationary cycling program) or to a control group (standard care) at 13±1 weeks of gestation. The primary outcome was a diagnosis of GDM. Secondary outcomes included maternal fitness, psychological well-being, and obstetric and neonatal outcomes. A sample size of 180 (90 in each group) was required to attain 80% power to detect a 40% reduction in the incidence of GDM.


RESULTS
Between June 2011 and July 2014, 205 women provided written consent and completed baseline assessments. Of these, 33 (16%) were subsequently excluded as a result of an elevated baseline oral glucose tolerance test (OGTT), leaving 172 randomized to exercise (n=85) or control (n=87). Three women miscarried before the assessment of outcome measures (control=2; exercise=1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40% [n=34]; exercise 40.5% [n=34]; P=.95) and the severity of GDM at diagnosis was unaffected by the exercise program with similar glucose and insulin responses to the OGTT (glucose 2 hours post-OGTT 7.7±1.5 compared with 7.6±1.6 mmol/L; P>.05). Maternal fitness was improved by the exercise program (P<.01) and psychological distress was reduced (P=.02). There were no differences in obstetric and neonatal outcomes between groups (P>.05).


CONCLUSIONS
Supervised home-based exercise started at 14 weeks of gestation did not prevent the recurrence of GDM; however, it was associated with important benefits for maternal fitness and psychological well-being.


BACKGROUND
ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.
School of Sport Science, Exercise and Health and the School of Women's and Infants' Health, the University of Western Australia, Perth, Western Australia, Australia.
Kym J
KJ
Guelfi
Ming Jing
MJ
Ong
Nicole A
NA
Crisp
Paul A
PA
Fournier
Karen E
KE
Wallman
J Robert
JR
Grove
Dorota A
DA
Doherty
John P
JP
Newnham
D000328:Adult; D016640:Diabetes, Gestational / Q000097:blood / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012008:Recurrence; D016896:Treatment Outcome