Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review

被引:60
作者
Harrison, Anne L. [1 ,2 ]
Shields, Nora [1 ,3 ]
Taylor, Nicholas F. [1 ,4 ]
Frawley, Helena C. [1 ,5 ]
机构
[1] La Trobe Univ, Sch Allied Hlth, Melbourne, Vic, Australia
[2] Werribee Mercy Hosp, Physiotherapy Dept, Melbourne, Vic, Australia
[3] Northern Hlth, Melbourne, Vic, Australia
[4] Eastern Hlth, Allied Hlth Clin Res Off, Melbourne, Vic, Australia
[5] Cabrini Hlth, Ctr Allied Hlth Res & Educ, Melbourne, Vic, Australia
关键词
Exercise; Gestational diabetes; Blood glucose; Pregnancy; Systematic review; GLUCOSE-TRANSPORT; BIRTH-WEIGHT; PEDRO SCALE; INSULIN; MANAGEMENT; METAANALYSIS; PREGNANCY; QUALITY; HUMANS;
D O I
10.1016/j.jphys.2016.08.003
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Question: Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus? Design: A systematic review of randomised trials. Participants: Pregnant women diagnosed with gestational diabetes mellitus. Intervention: Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism. Outcome measures: 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 -0.33 mmol/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 30 minutes, 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. Conclusion: 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. (C) 2016 Australian Physiotherapy Association. Published by Elsevier B.V.
引用
收藏
页码:188 / 196
页数:9
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