title: Effects of weekly supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: A systematic review and meta-analysis of randomized trials.
abstract: BACKGROUND
  Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, no meta-analysis has analyzed the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effects of weekly supervised exercise (EXE) or physical activity counseling (PA) in women with GDM compared with usual prenatal care (UPN) on glycemic control.
  
  
  METHODS
  Eligible trials were identified from Medline, EMBASE, Web of Science, Scopus and SportDiscus up to December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly supervised (at least once a week) prenatal exercise or PA counseling for which FBG values before and after intervention were available. Random-effects meta-analysis was performed for mean difference in FBG after exercise intervention.
  
  
  RESULTS
  The search yielded 781 publications, of which 82 were assessed for eligibility and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P = 0.11) compared with UPN. However, PA versus UPN showed a significant reduction in absolute FBG concentrations (weighted mean difference -3.88 mg/dL; 95% confidence interval -7.33, -0.42 mg/dL; I248%; Pheterogeneity< 0.15).
  
  
  CONCLUSIONS
  Physical activity counseling in women with GDM showed a significant effect compared with UPN on FBG concentrations, possibly due to a longer follow-up time compared with the EXE groups. This result highlights the importance of an early intervention that lasts to delivery for best practice of GDM management.
authors.affiliation: Obstetrics and Gynecology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.|Graduate Program in Health Sciences, Gynecology and Obstetrics, Porto Alegre, Brazil.
authors.forename: Roberta
authors.initials: R
authors.lastname: Bgeginski
authors.affiliation: Postgraduate Studies Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
authors.forename: Paula A B
authors.initials: PAB
authors.lastname: Ribeiro
authors.affiliation: Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, R. Samuel McLaughlin Foundation Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Canada.|Children's Health Research Institute, London, Canada.
authors.forename: Michelle F
authors.initials: MF
authors.lastname: Mottola
authors.affiliation: Obstetrics and Gynecology Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.|Graduate Program in Health Sciences, Gynecology and Obstetrics, Porto Alegre, Brazil.
authors.forename: José Geraldo L
authors.initials: JGL
authors.lastname: Ramos
mesh_terms: D000328:Adult; D001724:Birth Weight; D001786:Blood Glucose / Q000378:metabolism*; D003376:Counseling / Q000379:methods*; D016640:Diabetes, Gestational / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005215:Fasting / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008019:Life Style; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic
chemical_list: D001786:Blood Glucose
keywords: exercise; glycemic control; hyperglycemia; insulin resistance; pregnancy; 妊娠; 胰岛素抵抗; 血糖控制; 运动; 高血糖