Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial

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Abstract

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.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 (n85) or control (n87). Three women miscarried before the assessment of outcome measures (control2; exercise1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40% [n34]; exercise 40.5% [n34]; 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.05). CONCLUSION: 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.
CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.
Original languageEnglish
Pages (from-to)819-827
Number of pages9
JournalObstetrics and Gynecology
Volume128
Issue number4
Early online date5 Sep 2016
DOIs
Publication statusPublished - Oct 2016

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Gestational Diabetes
Randomized Controlled Trials
Exercise
Recurrence
Glucose Tolerance Test
Mothers
Obstetrics
Psychology
Glucose
Pregnancy
Control Groups
Sample Size
Outcome Assessment (Health Care)
Insulin
Incidence
Health

Cite this

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title = "Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial",
abstract = "{\circledC} 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.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 (n85) or control (n87). Three women miscarried before the assessment of outcome measures (control2; exercise1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40{\%} [n34]; exercise 40.5{\%} [n34]; 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.05). CONCLUSION: 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.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.",
author = "Kym Guelfi and M.J. Ong and Nicole Crisp and Paul Fournier and Karen Wallman and Bob Grove and Dorota Doherty and John Newnham",
year = "2016",
month = "10",
doi = "10.1097/AOG.0000000000001632",
language = "English",
volume = "128",
pages = "819--827",
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T1 - Regular exercise to prevent the recurrence of gestational diabetes mellitus

T2 - a randomized controlled trial

AU - Guelfi, Kym

AU - Ong, M.J.

AU - Crisp, Nicole

AU - Fournier, Paul

AU - Wallman, Karen

AU - Grove, Bob

AU - Doherty, Dorota

AU - Newnham, John

PY - 2016/10

Y1 - 2016/10

N2 - © 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.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 (n85) or control (n87). Three women miscarried before the assessment of outcome measures (control2; exercise1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40% [n34]; exercise 40.5% [n34]; 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.05). CONCLUSION: 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.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.

AB - © 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.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 (n85) or control (n87). Three women miscarried before the assessment of outcome measures (control2; exercise1). All remaining women completed the postintervention OGTT. The recurrence rate of GDM was similar between groups (control 40% [n34]; exercise 40.5% [n34]; 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.05). CONCLUSION: 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.CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT01283854.

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DO - 10.1097/AOG.0000000000001632

M3 - Article

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EP - 827

JO - Obstetrics & Gynecology:

JF - Obstetrics & Gynecology:

SN - 0029-7844

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