title: Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.
abstract: OBJECTIVE
  Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus?
  
  
  METHODS
  A systematic review of randomised trials.
  
  
  METHODS
  Pregnant women diagnosed with gestational diabetes mellitus.
  
  
  METHODS
  Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism.
  
  
  METHODS
  Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence.
  
  
  RESULTS
  This systematic review identified eight randomised, controlled trials involving 588 participants; seven 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 standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/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 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise.
  
  
  CONCLUSIONS
  Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus.
  
  
  BACKGROUND
  PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196].
authors.affiliation: School of Allied Health, La Trobe University; Physiotherapy Department, Werribee Mercy Hospital.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Harrison
authors.affiliation: School of Allied Health, La Trobe University; Northern Health.
authors.forename: Nora
authors.initials: N
authors.lastname: Shields
authors.affiliation: School of Allied Health, La Trobe University; Allied Health Clinical Research Office, Eastern Health.
authors.forename: Nicholas F
authors.initials: NF
authors.lastname: Taylor
authors.affiliation: School of Allied Health, La Trobe University; Centre for Allied Health Research and Education, Cabrini Health, Melbourne, Australia.
authors.forename: Helena C
authors.initials: HC
authors.lastname: Frawley
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D016640:Diabetes, Gestational / Q000097:blood* / Q000503:physiopathology; D015444:Exercise / Q000502:physiology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D011247:Pregnancy
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Blood glucose; Exercise; Gestational diabetes; Pregnancy; Systematic review