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Abstract

Background

Gestational diabetes mellitus affects millions of pregnant women. Lifestyle intervention is recommended as the first-line treatment, in which exercise plays an important role. Effective and safe exercise is required to facilitate glycaemic control and improve delivery outcomes.

Objective

To investigate the efficacy and safety of the original Gymnastics for Pregnant Women program for glycaemic control and delivery outcomes improvement in gestational diabetes mellitus women.

Design

The study was a two-arm parallel randomized controlled clinical trial.

Setting

The study was conducted in a tertiary specialized maternity hospital in Hangzhou, China.

Participants

Totally 131 eligible pregnant women were enrolled from June to December 2020.

Methods

Participants were randomly allocated to the control group (conventional intervention) or experimental group that engaged in the original Gymnastics for Pregnant Women program. The primary outcomes included glycaemic control during pregnancy and postpartum. Secondary outcomes included adverse events, maternal and neonatal outcomes.

Results

Participants showed a significant improvement in glycaemic control after engaging in the intervention for 2?weeks; the improvement was most significant in terms of the 2-h postprandial plasma glucose (P?<?0.05). The fasting blood glucose and 2-h postprandial plasma glucose data indicated a higher glycaemic control rate in the experimental than control group (86.16% vs. 66.67%, P?=?0.008; and 84.62% vs. 36.36% [6.09?±?0.79 vs. 6.96?±?1.06?mmol/L], P?<?0.001, respectively). After delivery, the 2-h oral glucose tolerance test results indicated better glycaemic control in the experimental than control group (75.44% vs. 57.41% [6.93?±?1.44 vs. 7.79?±?2.03?mmol/L], P?=?0.047). Additionally, the 2-h oral glucose tolerance test in the experimental group with reasonable exercise frequency (≥ 10 times per week) had the best glucose level (6.81?±?1.30?mmol/L), followed by the experimental group with a lower exercise frequency (< 10 times per week) (7.35?±?1.83?mmol/L) and the control group (7.79?±?2.03?mmol/L). No statistical differences in maternal or neonatal outcomes were observed between the control and experimental groups (P?>?0.05). In addition, there were no adverse events in the experimental group; however, in the control group, two cases experienced at least one hypoglycaemic episode and two cases received insulin during the study period.

Conclusions

The original Gymnastics for Pregnant Women was associated with greater improvements in blood glucose levels during pregnancy and postpartum compared with a conventional intervention for women with gestational diabetes mellitus.

摘要翻譯（僅供參考）

背景

妊娠期糖尿病影響著數(shù)百萬孕婦。建議將生活方式干預(yù)作為一線治療，其中運動起著重要作用。需要有效和安全的運動來促進(jìn)血糖控制和改善分娩結(jié)果。

目標(biāo)

目的探討妊娠期糖尿病患者應(yīng)用原體體操項目控制血糖、改善分娩結(jié)局的有效性和安全性。

設(shè)計

本研究是一項雙臂平行隨機(jī)對照臨床試驗。

場所

該研究在中國杭州的一家三級?？茓D產(chǎn)醫(yī)院進(jìn)行。

參與者

2020年6月至12月共納入131名符合條件的孕婦。

方法

參與者被隨機(jī)分配到對照組(常規(guī)干預(yù))或試驗組從事孕婦體操項目。主要結(jié)果包括妊娠期和產(chǎn)后血糖控制。次要結(jié)局包括不良事件、孕產(chǎn)婦和新生兒結(jié)局。

結(jié)果

干預(yù)2?周后患者血糖控制有明顯改善;以餐后2 h血糖改善最為顯著(P?<?0.05)。空腹血糖和餐后2小時血糖數(shù)據(jù)顯示，試驗組血糖控制率高于對照組(86.16% vs. 66.67%， P?=?0.008;和84.62%和36.36%[6.09?±?0.79 vs 6.96?±1.06??更易/ L), P?<?0.001,分別)。分娩后2小時口服糖耐量試驗結(jié)果顯示，試驗組血糖控制優(yōu)于對照組(75.44%∶57.41%[6.93?±?1.44∶7.79?±?2.03?mmol/L]， P?=?0.047)。此外,實驗組2 h口服葡萄糖耐量試驗的合理的運動頻率(每周≥10次)最好的血糖水平(6.81?±1.30??更易/ L),緊隨其后的是實驗組運動頻率較低(< 10次/周)(7.35?±1.83??更易/ L)和對照組(7.79?±2.03??更易/ L)。對照組與實驗組產(chǎn)婦及新生兒結(jié)局無統(tǒng)計學(xué)差異(P?>?0.05)。試驗組無不良事件發(fā)生;然而，在對照組中，2例至少經(jīng)歷了一次低血糖發(fā)作，2例在研究期間接受了胰島素治療。

結(jié)論

與妊娠期糖尿病患者的常規(guī)干預(yù)相比，孕婦體操與妊娠期和產(chǎn)后血糖水平有更大的改善。

THE

END

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