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Cui H, Li H, Huang J, Wu Y, Wei Y, Li M. The effect of exercise on the adverse neonatal outcomes related to women with gestational diabetes mellitus: a systematic review and meta-analysis. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2025; 6:1566577. [PMID: 40235647 PMCID: PMC11997568 DOI: 10.3389/fcdhc.2025.1566577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Accepted: 03/12/2025] [Indexed: 04/17/2025]
Abstract
This meta-analysis aimed to evaluate the benefits of prenatal exercise on neonatal outcomes in women with gestational diabetes mellitus (GDM). Systematic searches were conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus from their inception to September 9, 2023. ClinicalTrials.gov was also searched to ensure comprehensive coverage. We included studies that investigated the association between prenatal exercise and at least one adverse neonatal outcome of interest. A total of 4,268 publications were retrieved, and 3,060 records remained after removing duplicates. After screening abstracts, 107 studies were selected for full-text assessment, and ultimately, 17 articles (including 4 identified through manual searching) were included for data extraction. Extracted information included the first author, publication year, study design, geographical location, sample size, participants' demographic characteristics, intervention characteristics, and relevant outcome variables.Pooled results from random-effects models showed that prenatal exercise significantly reduced the risk of adverse neonatal outcomes, including: Cesarean delivery (OR = 0.91, 95% CI: 0.88-0.94), Premature birth (OR = 0.49, 95% CI: 0.27-0.90), Macrosomia (OR = 0.58, 95% CI: 0.40-0.83), Fetal growth restriction (OR = 0.21, 95% CI: 0.08-0.52), and Birth trauma (OR = 0.26, 95% CI: 0.13-0.54). Subgroup analyses indicated that single-component exercise programs were more effective than multi-component programs in reducing the risk of macrosomia (P = 0.06). In conclusion, prenatal exercise substantially reduces the risk of multiple adverse neonatal outcomes in women with GDM, including macrosomia, preterm birth, cesarean delivery, fetal growth restriction, and birth trauma. These findings highlight the outstanding benefits of antenatal exercise for fetal health, supporting its inclusion as a key component of prenatal care for women with GDM. This meta-analysis is registered with PROSPERO (Registration Number: CRD42023485375).
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Affiliation(s)
- Hangyu Cui
- School of Nursing, Peking University, Beijing, China
| | - Hua Li
- School of Nursing, Peking University, Beijing, China
| | - Jing Huang
- School of Nursing, Peking University, Beijing, China
| | - Yi Wu
- School of Nursing, Peking University, Beijing, China
| | - Yuan Wei
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
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Apte S, Ramachandra P, Guruvare S, Bhat SK, Maiya GA. Development, validation, and pilot testing of the physical activity promotion program booklet for women with gestational diabetes mellitus. Women Health 2025; 65:302-313. [PMID: 40177716 DOI: 10.1080/03630242.2025.2480838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 02/16/2025] [Accepted: 03/12/2025] [Indexed: 04/05/2025]
Abstract
Physical Activity (PA) promotion is an essential component of the comprehensive management of Gestational Diabetes Mellitus (GDM). Even though the literature is available regarding the importance of PA, limited access to reliable sources of information hinders involvement in recommended PA during pregnancy. The present study aims to develop, validate, and pilot test the Physical Activity Promotion Program (PAPP) booklet for women with GDM. The booklet was developed based on the previous literature, validated by seven experts, and administered to 38 participants for 8 weeks. The level of PA was evaluated with the Global Physical Activity Questionnaire before and after the intervention. The Scale Content Validity Index of the booklet was 0.98. The Flesch readability ease score and Flesch Kincaid grade level were 62 and 6.9, respectively. The validation scores showed that the booklet is appropriate and the readability score indicated a "standard" description style. There was a significant increase in the level of PA (MD = -320, 95% CI = -360, -250, d = -0.96, p < .001) and reduced Sedentary Behavior (MD = 45, 95% CI = 37.5, 60, d = 1, p < .001) post-intervention. The PAPP booklet was found to be a valid and reliable source of information and improves the level of PA among women with GDM.
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Affiliation(s)
- Savni Apte
- Department of Physiotherapy, Centre for Podiatry & Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Preetha Ramachandra
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shyamala Guruvare
- Department of Obstetrics and Gynecology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Shashikala K Bhat
- Department of Obstetrics and Gynaecology, Melaka Manipal Medical College (Manipal Campus), Dr. TMA Pai Hospital, Udupi, Manipal Academy of Higher Education, Manipal, India
| | - G Arun Maiya
- Centre for Podiatry & Diabetic Foot Care and Research, Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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Dong L, Zhong W, Qiao T, Wang Z, Liang Y, Zhao DQ. Investigation and study on the epidemiology of gestational diabetes mellitus in Guizhou. World J Diabetes 2025; 16:98438. [PMID: 39959259 PMCID: PMC11718487 DOI: 10.4239/wjd.v16.i2.98438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 10/19/2024] [Accepted: 11/25/2024] [Indexed: 12/30/2024] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a growing public health concern, particularly in regions with diverse ethnic populations. Understanding the incidence and risk factors of GDM is crucial for early prevention and management, especially in underrepresented areas like Guizhou Province, China, where geographic and ethnic diversity may influence the disease's prevalence and risk profiles. AIM To investigate the incidence of GDM and identify its associated risk and protective factors among different ethnic groups in Guizhou Province, providing essential data for early prevention strategies. METHODS A multi-center retrospective study was conducted, dividing participants into GDM and non-GDM groups according to standardized diagnostic criteria. Data were collected from 103629 deliveries across 40 hospitals in Guizhou. Various demographic, clinical, and laboratory parameters were analyzed using logistic regression to identify risk and protective factors for GDM. RESULTS Among the 103629 deliveries, 18957 cases of GDM were identified, with an incidence of approximately 18.3%. The risk of GDM was higher in the Han ethnic group compared to minority ethnic groups. The Dong ethnic group had the lowest incidence among the minorities. Key risk factors identified included older age (especially > 35 years), higher pre-pregnancy body mass index (BMI), light physical activity, gravidity, family history of diabetes, hemoglobin, aspartate aminotransferase, alanine aminotransferase, and direct bilirubin. Protective factors included higher education level, total protein, and albumin. There were also differences based on blood type, with type A associated with higher risk. CONCLUSION The incidence rate in Guizhou is 18.3%. Older age (especially > 35 years), Han ethnicity, lower education level, higher pre-pregnancy BMI, light physical activity, and higher gravidity are the main risk factors for GDM. Laboratory findings indicate that higher hemoglobin, higher liver function parameters (alanine aminotransferase, aspartate aminotransferase, and direct bilirubin), and lower total protein and albumin are associated with a higher risk of GDM. Blood type A has a higher risk of GDM compared to blood types AB and O.
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Affiliation(s)
- Lin Dong
- Department of Obstetrics and Gynecology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Wei Zhong
- Department of Obstetrics and Gynecology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Tian Qiao
- Department of Clinical Nutrition, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Zhuo Wang
- Department of Obstetrics and Gynecology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Yi Liang
- Department of Clinical Nutrition, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
| | - Dan-Qing Zhao
- Department of Obstetrics and Gynecology, Guizhou Medical University, Guiyang 550000, Guizhou Province, China
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Zhang L, Wang F, Tashiro S, Liu PJ. Effects of Dietary Approaches and Exercise Interventions on Gestational Diabetes Mellitus: A Systematic Review and Bayesian Network Meta-analysis. Adv Nutr 2024; 15:100330. [PMID: 39481539 PMCID: PMC11629230 DOI: 10.1016/j.advnut.2024.100330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 10/01/2024] [Accepted: 10/23/2024] [Indexed: 11/02/2024] Open
Abstract
Although lifestyle interventions are recommended as the frontline therapeutic strategy for women with gestational diabetes mellitus (GDM), the optimal dietary regimen or form of exercise has yet to be definitively established. We aimed to compare the effectiveness of lifestyle therapies for GDM. Four databases (PubMed, Web of Science, EMBASE, and Cochrane Library) were systematically searched by multiple researchers for randomized controlled trials (RCTs). RCTs comparing lifestyle therapies to treat GDM with control or another treatment were included. Data extraction and synthesis were performed, estimating mean differences (MDs) or relative risk (RR) through pair-wise and network meta-analysis with a randomized or fixed-effects model when appropriate. The primary outcomes were maternal glucose control, birth weight of newborns, macrosomia and preterm birth rate, and rate of need for insulin therapy. In total, 39 trials with information obtained from 2712 women assessed 15 treatments. After sensitivity analysis, we confirmed the dietary approaches to stop hypertension (DASH) diet [MD: -11.52; 95% credible intervals (CrIs): -14.01, -9.07, very low certainty of evidence (CoE)] and low glycemic index (GI) diets (MD: -6.3; 95% CrI: -9.9, -2.7, low CoE) have shown significant advantages in fasting plasma glucose and 2-h postprandial glucose control, respectively. Furthermore, the DASH diet and resistance exercise reduced insulin requirements independently by 71% (95% CrI: 52%, 84%) and 67% (95% CrI: 48%, 85%), respectively. Additionally, both the DASH (MD: -587.6; 95% CrI: -752.12, -421.85, low CoE) and low GI diets (MD: -180.09, 95% CrI: -267.48, -94.65, low CoE) reduced birth weight significantly, with the DASH diet also demonstrating effects in reducing macrosomia by 89% (95% CrI: 53%, 98%) and lowering the cesarean section rate by 46% (95% CI: 27%, 60%). However, exercise did not affect infant outcomes. Our findings suggest that the DASH diet and low GI diet and resistance exercise may be beneficial for maternal outcomes in pregnancies with GDM. The impact on infants is primarily observed through dietary interventions. Future research, characterized by higher quality and evidence grades, is necessary to complement and substantiate our findings. This study was registered with PROSPERO as CRD 42024527587.
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Affiliation(s)
- Liang Zhang
- Department of Rehabilitation Medicine, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Fang Wang
- Department of Clinical Nutrition, Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, PR China
| | - Syoichi Tashiro
- Department of Rehabilitation Medicine, Kyorin University Faculty of Medicine, Tokyo, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Peng Ju Liu
- Department of Clinical Nutrition, Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, PR China.
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Xu H, Liu R. Comprehensive management of gestational diabetes mellitus: practical efficacy of exercise therapy and sustained intervention strategies. Front Endocrinol (Lausanne) 2024; 15:1347754. [PMID: 39421534 PMCID: PMC11484007 DOI: 10.3389/fendo.2024.1347754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 09/10/2024] [Indexed: 10/19/2024] Open
Abstract
Background Gestational Diabetes Mellitus (GDM) affects 14.0% of pregnancies globally, with a 35% post-pregnancy relapse and a 60% risk of Type 2 Diabetes (T2D) within 5-10 years. Challenges in long-term management, especially postpartum, include adherence and follow-up difficulties. Methods This study, based on a systematic review and meta-analysis, examined the practical effects of exercise therapy in the prevention, treatment, and prevention of progression from Gestational Diabetes Mellitus (GDM) to Type 2 Diabetes (T2D). Relevant research and clinical practices were retrieved from six major databases (PubMed, Scopus, Web of Science, Cochrane Library, MEDLINE, Science Direct). After analyzing the intervention effects of exercise therapy at different stages, factors favorably influencing the effectiveness of exercise intervention were identified during the more effective stages. Finally, a long-term and efficient exercise implementation plan for the comprehensive management of GDM was proposed. Results In GDM prevention, exercise reduced the post-intervention risk by 37% compared to the control group (Relative Risk (RR)=0.63; 95% Confidence Interval (CI): 0.54 to 0.72; p=0.01). Studies on GDM treatment showed improved glucose control in the exercise group post-intervention (Mean Difference (MD)=-0.10; 95% CI: -0.16 to -0.04; p=0.04/MD=-0.27; 95% CI: -0.36 to -0.19; p<0.0001). However, exercise therapy didn't significantly affect the incidence of T2D post-GDM (RR=0.88; 95% CI: 0.69 to 1.11; p=0.39) due to challenges in quantified exercise prescriptions and the complexity of postpartum programs. Conclusion To enhance exercise therapy effectiveness in GDM management, the study recommends adopting an integrated model emphasizing personalized pregnancy plans, postpartum strategies, and long-term support. Leveraging frequent healthcare contact during pregnancy can establish and sustain exercise habits, fostering a lifelong pattern. While the study acknowledges limitations, this approach holds potential for improving glycemic metabolism and developing healthy exercise habits in subsequent generations. Future research should include longer follow-ups to validate the practical efficacy of this approach in preventing T2D after GDM. Systematic review registration https://www.crd.york.ac.uk/prospero, identifier CRD42023463617.
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Chen S, Zhang H. Clinical effect of anti-resistance exercise combined with nutritional intervention in the treatment of elderly patients with sarcopenia. Medicine (Baltimore) 2024; 103:e39472. [PMID: 39287274 PMCID: PMC11404919 DOI: 10.1097/md.0000000000039472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/29/2024] [Accepted: 08/07/2024] [Indexed: 09/19/2024] Open
Abstract
This study aims to evaluate the efficacy of a combined intervention involving resistance exercise and nutritional support in improving grip strength, walking speed, and skeletal muscle density among elderly individuals suffering from sarcopenia. Data from a cohort of 500 elderly sarcopenic patients were segregated into observation and control cohorts based on distinct treatment modalities. Baseline evaluations included weight, grip strength, walking speed, and skeletal muscle density. Changes in these parameters and oxidative stress markers were monitored and compared at 1-, 3-, and 6-month intervals. Baseline grip strength for the observation and control groups stood at (20.25 ± 2.34) and (21.06 ± 2.97) kg, respectively. Walking speed was measured at (0.99 ± 0.12) and (0.98 ± 0.20) m/s, respectively. Skeletal muscle density registered (42.98 ± 4.17) and (42.77 ± 5.02) Hu for the observation and control groups, respectively, while muscle mass index was recorded as (6.19 ± 1.46) and (6.20 ± 1.68) kg/m2, respectively. Limb skeletal muscle mass for both cohorts was (16.83 ± 3.57) and (16.77 ± 3.89) kg. No significant disparities were discerned in baseline characteristics between the groups. Following 1, 3, and 6 months, the observation group exhibited marked enhancements in grip strength and walking speed (P < .05), with substantially superior grip strength compared to the control cohort (P < .05). Notably, skeletal muscle density, muscle mass index, and limb skeletal muscle mass exhibited significant augmentation in the observation group (P < .05), while no significant alterations were observed in the control cohort. Oxidative stress-related parameters displayed no notable differences between groups pretreatment (P > .05). Post-treatment, levels of Hcy, IFN-γ, and MDA markedly decreased in both groups, with considerably lower levels evident in the observation cohort (P < .05). Moreover, SOD levels exhibited significant post-treatment increments in both groups, with markedly higher levels observed in the observation group (P < .05). An integrated approach of resistance exercise and nutritional support significantly enhances grip strength, walking speed, and skeletal muscle density in elderly patients with sarcopenia, contributing to better prognoses and improved quality of life.
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Affiliation(s)
- Sheng Chen
- Department of Orthopedics, Xiantao First People’s Hospital, Xiantao, China
| | - Hao Zhang
- Department of Orthopedics, Qianjiang Central Hospital, Qianjiang, China
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Del Campo-Rota IM, Delgado-Casillas OM, Ibarra A. Cognitive Impairment Induced by Gestational Diabetes: The Role of Oxidative Stress. Arch Med Res 2024; 55:103016. [PMID: 38870549 DOI: 10.1016/j.arcmed.2024.103016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/01/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Cognitive impairment is defined as a neurological condition that alters multiple cerebral functions such as reasoning, memory, concentration, and association, among others. It has found to be widely correlated with several factors such as oxidative stress. The latter could be induced by numerous pathological conditions characterized by increased levels of free radicals and decreased levels of antioxidants. Pregnancy is a period when women undergo a physiological state of oxidative stress due to hormonal changes and increased oxygen requirements to maintain pregnancy. However, when oxidative stress exceeds antioxidant capacity, this leads to cellular damage that promotes a diabetogenic state. Recent studies suggest a possible association between gestational diabetes and cognitive impairment, but the underlying mechanisms remain unclear. AIMS We aim to explore the pathophysiological relationship between cognitive impairment and oxidative stress, focusing on the possible involvement of oxidative stress as the inducing mechanism. METHODS We performed a comprehensive literature review through PubMed and Google Scholar. Our keywords were "neuroinflammation", "cognitive impairment", "gestational diabetes", "oxidative stress", "antioxidants", and "free radicals". RESULTS From the initial 400 records identified, a total of 78 studies were analyzed and included in our study. CONCLUSION Oxidative stress plays a fundamental role in the development of cognitive impairment. Understanding this correlation is essential to the development of targeted medical interventions and, ultimately, promote research and prevention that will benefit the mother-child binomial in the short and long term.
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Affiliation(s)
- Isabel Martin Del Campo-Rota
- Centro de Investigación en Ciencias de la Salud, Universidad Anáhuac México, Campus Norte, Huixquilucan, Edo. de México, Mexico
| | - Oscar Mario Delgado-Casillas
- Centro de Investigación en Ciencias de la Salud, Universidad Anáhuac México, Campus Norte, Huixquilucan, Edo. de México, Mexico
| | - Antonio Ibarra
- Centro de Investigación en Ciencias de la Salud, Universidad Anáhuac México, Campus Norte, Huixquilucan, Edo. de México, Mexico; Secretaría de la Defensa Nacional, Escuela Militar de Graduados en Sanidad, Ciudad de México, Mexico.
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Duchette C, Perera M, Arnett S, White E, Belcher E, Tinius R. Benefits of Resistance Training During Pregnancy for Maternal and Fetal Health: A Brief Overview. Int J Womens Health 2024; 16:1137-1147. [PMID: 38912201 PMCID: PMC11193983 DOI: 10.2147/ijwh.s462591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/11/2024] [Indexed: 06/25/2024] Open
Abstract
Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize the importance of resistance exercise and provide minimal guidance. With a large increase in strength-focused sports among women, it is critical to re-evaluate the risk/benefit ratio of these exercises and ensure the latest recommendations reflect the latest clinical research. The purpose of this review is to highlight the safety and benefits of resistance training for both maternal and fetal health, particularly focusing on recent work. Relevant research involving resistance training during pregnancy was accessed and analyzed via a quasi-systematic search. Results demonstrate that appropriate prenatal resistance training can help alleviate some of the common symptoms of pregnancy, such as fatigue, back pain, and poor mental health. Resistance exercise can assist with glucose control in gestational diabetes mellitus, as well as decrease the risk of infant macrosomia and childhood metabolic dysfunction associated with uncontrolled gestational diabetes. Resistance training can also increase the likelihood of a vaginal delivery, which is beneficial for both mother and baby. Concerning fetal health, resistance training increases uterine blood flow, decreases the risk of neonatal macrosomia, and improves cognitive function and metabolic health in childhood. As with all forms of exercise, pregnant women should avoid resistance exercises that involve the supine position for extended bouts of time, trauma (or risk of trauma) to the abdomen, ballistic movements, movements that rely heavily on balance, and conditions that prohibit appropriate temperature control. With these considerations in mind, resistance training's benefits far surpass the lack of risk to the fetus. Resistance training is a safe and effective way to improve and maintain physical fitness during pregnancy and represents no risk to fetal health and development. Thus, healthcare providers should recommend resistance training for pregnant women.
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Affiliation(s)
| | - Madhawa Perera
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Scott Arnett
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Erin White
- Health, Exercise, and Rehabilitative Sciences, Winona State University, Winona, Minnesota, USA
| | - Elizabeth Belcher
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Rachel Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
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Xie YP, Lin S, Xie BY, Zhao HF. Recent progress in metabolic reprogramming in gestational diabetes mellitus: a review. Front Endocrinol (Lausanne) 2024; 14:1284160. [PMID: 38234430 PMCID: PMC10791831 DOI: 10.3389/fendo.2023.1284160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 01/19/2024] Open
Abstract
Gestational diabetes mellitus is a prevalent metabolic disease that can impact the normal course of pregnancy and delivery, leading to adverse outcomes for both mother and child. Its pathogenesis is complex and involves various factors, such as insulin resistance and β-cell dysfunction. Metabolic reprogramming, which involves mitochondrial oxidative phosphorylation and glycolysis, is crucial for maintaining human metabolic balance and is involved in the pathogenesis and progression of gestational diabetes mellitus. However, research on the link and metabolic pathways between metabolic reprogramming and gestational diabetes mellitus is limited. Therefore, we reviewed the relationship between metabolic reprogramming and gestational diabetes mellitus to provide new therapeutic strategies for maternal health during pregnancy and reduce the risk of developing gestational diabetes mellitus.
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Affiliation(s)
- Ya-ping Xie
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Shu Lin
- Centre of Neurological and Metabolic Research, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
- Group of Neuroendocrinology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Bao-yuan Xie
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
| | - Hui-fen Zhao
- Nursing Department, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China
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Díaz-Goñi V, Cavero-Redondo I, Bizzozero-Peroni B, Rodríguez-Gutiérrez E, Pascual-Morena C, Sequí-Domínguez I, Lucas-Torres ML, de Arenas-Arroyo SN, Saz-Lara A. Comparative effect of different types of physical exercise and intensity levels on low birth weight: A systematic review and network meta-analysis. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241276253. [PMID: 39320857 PMCID: PMC11425745 DOI: 10.1177/17455057241276253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 07/11/2024] [Accepted: 07/18/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Low birth weight (LBW) has been established as a major determinant of neonatal mortality and morbidity. However, there is no evidence of the effectiveness of different types of physical exercise (PE) at different intensities during pregnancy to prevent LBW. OBJECTIVES To compare the effectiveness of different types of PE at different levels of intensity in pregnant women to prevent LBW. DESIGN A systematic review and network meta-analysis was performed according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols for Network Meta-Analysis extension statement. DATA SOURCES AND METHODS We searched the PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Web of Science databases from inception to November 2023. We included randomized controlled trials (RCTs). A random effects method was used to calculate the pooled mean difference (MD). The effect of each intervention was calculated using a network meta-analysis with a frequentist perspective. RESULTS Forty-three RCTs were included in the systematic review, and 38 RCTs were included in the network meta-analysis. In the general population, although no significant results, the MDs for light-moderate strength, moderate-vigorous strength, and moderate-vigorous Pilates exercises were favorable for preventing LBW. Furthermore, moderate-vigorous strength exercise was effective to prevent LBW, reporting significant MD compared to control groups in the healthy population (310.00, 95% confidence interval: 78.40, 541.60; I2 = 81.3%). CONCLUSION Strength exercises at a moderate-vigorous intensity could be a potential strategy for the prevention of LBW in the healthy population. However, our findings should be interpreted with caution because the overall risk of bias was between "some concerns" and "high," and the overall certainty of the evidence was low. REGISTRATION PROSPERO CRD42023401770.
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Affiliation(s)
- Valentina Díaz-Goñi
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Iván Cavero-Redondo
- CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
| | - Bruno Bizzozero-Peroni
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Higher Institute of Physical Education, Universidad de la República, Rivera, Uruguay
| | - Eva Rodríguez-Gutiérrez
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
| | - Carlos Pascual-Morena
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Faculty of Nursing of Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | - Irene Sequí-Domínguez
- Health and Social Research Centre, Universidad de Castilla-La Mancha, Cuenca, Spain
- Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), Cuenca, Spain
- Faculty of Nursing of Albacete, Universidad de Castilla-La Mancha, Albacete, Spain
| | | | | | - Alicia Saz-Lara
- CarVasCare Research Group (2023-GRIN-34459), Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain
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Zhou XY, Wang YF, Yang JM, Yang LY, Zhao WJ, Chen YL, Yang QH. Latent profile analysis and influencing factors of quality of life in pregnant women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2023; 23:785. [PMID: 37951868 PMCID: PMC10638685 DOI: 10.1186/s12884-023-06079-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE Gestational diabetes mellitus (GDM) negatively affects the quality of life of pregnant women and is influenced by several factors. Research to date treats pregnant women with gestational diabetes as a homogeneous group based on their quality of life. We attempted to identify subgroups based on self-reported quality of life and explored variables associated with subgroups. METHODS From September 1, 2020 to November 29, 2020, pregnant women with GDM from two hospitals in Guangdong Province were selected as subjects by convenience sampling method. Medical records provided sociodemographic data, duration of GDM, pregnancy status, and family history of diabetes. Participants completed validated questionnaires for quality of life, anxiety and depression. Latent profile analysis was used to identify profiles of quality of life in pregnant women with GDM, and then a mixed regression method was used to analyze the influencing factors of different profiles. RESULTS A total of 279 valid questionnaires were collected. The results of the latent profile analysis showed that the quality of life of pregnant women with GDM could be divided into two profiles: C1 "high worry-high support" group (75.6%) and C2 "low worry-low support" group (24.4%). Daily exercise duration and depression degree are negative influencing factors, making it easier to enter the C1 group (p < 0.05). Disease duration and family history of diabetes are positive influencing factors, making it easier to enter the C2 group (p < 0.05). CONCLUSION The quality of life of pregnant women with GDM had obvious classification characteristics. Pregnant women with exercise habits and depression are more likely to enter the "high worry-high support" group, and health care providers should guide their exercise according to exercise guidelines during pregnancy and strengthen psychological intervention. Pregnant women with a family history of diabetes and a longer duration of the disease are more likely to fall into the "low worry-low support" group. Healthcare providers can strengthen health education for them and improve their disease self-management abilities.
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Affiliation(s)
- Xin-Yi Zhou
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Yan-Feng Wang
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Jie-Mei Yang
- Department of Obstetrics, Zhuhai Maternal and Child Health Hospital, Zhuhai, Guangdong, 519001, China
| | - Li-Yuan Yang
- Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, 510620, China
| | - Wei-Jia Zhao
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Yan-Ling Chen
- School of Health, Dongguan Vocational and Technical College, Dongguan, Guangdong, 523808, China.
| | - Qiao-Hong Yang
- School of Nursing, Jinan University, Guangzhou, Guangdong, 510632, China.
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Mu J, Guo X, Zhou Y, Cao G. The Effects of Probiotics/Synbiotics on Glucose and Lipid Metabolism in Women with Gestational Diabetes Mellitus: A Meta-Analysis of Randomized Controlled Trials. Nutrients 2023; 15:nu15061375. [PMID: 36986107 PMCID: PMC10056932 DOI: 10.3390/nu15061375] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/17/2023] Open
Abstract
Background: Gestational diabetes mellitus (GDM) is prevalent with lasting health implications for the mother and offspring. Medical therapy is the foundation of GDM management, for achieving optimal glycemic control often requires treatment with insulin or metformin. Gut dysbiosis is a feature of GDM pregnancies, therefore, dietary manipulation of the gut microbiota may offer a new avenue for management. Probiotics are a relatively new intervention, which can reduce the mother’s blood sugar levels and, furthermore, adjust glucose and lipid metabolism in both mother and offspring. Objective: The aim of this systematic review and meta-analysis is to explore the effect of probiotics/synbiotics on glucose and lipid metabolism in women with GDM. Methods: A systematic search of the literature was conducted using the electronic databases Cochrane Library, Web of Science, PubMed, and EBOSCO, published between 1 January 2012 and 1 November 2022. A total of 11 randomized controlled clinical trials (RCTs) were analyzed. The indicators included fasting plasma glucose (FPG), fasting serum insulin (FSI), the homoeostatic model assessment for insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), total cholesterol (TC), HDL cholesterol, LDL cholesterol and triglycerides (TG), the mean weight at end of trial, and gestational weight gain (GWG). Results: Compared with the placebo, probiotics/synbiotics were associated with a statistically significant improvement in FPG (MD = −2.33, 95% CI = −4.27, −0.40, p = 0.02), FSI (MD = −2.47 95% CI = −3.82, −1.12, p = 0.0003), HOMA-IR (MD = −0.40, 95% CI = −0.74, −0.06, p = 0.02), and TC (MD = −6.59, 95% CI = −12.23,−−0.95, p = 0.02), while other factors had no significant difference. The subgroup analysis revealed that the kind of supplement led to heterogeneity for FPG and FSI, while heterogeneity was not found for others. Conclusion: Probiotics/synbiotics could control glucose and lipid metabolism in pregnant women with GDM. There was a significant improvement in FPG, FSI, HOMA-IR, and TC. The use of specific probiotic supplementation may be a promising prevention and therapeutic strategy for GDM. However, due to the heterogeneity among existing studies, further studies are warranted to address the limitations of existing evidence and better inform the management of GDM.
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Affiliation(s)
- Jinhao Mu
- Sport Science School, Beijing Sport University, Beijing 100084, China
| | - Xian Guo
- Sport Science School, Beijing Sport University, Beijing 100084, China
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing 100084, China
- Correspondence:
| | - Yanbing Zhou
- School of Art, Beijing Sport University, Beijing 100084, China
| | - Guoxia Cao
- Sport Science School, Beijing Sport University, Beijing 100084, China
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Allman BR, McDonald S, May L, Børsheim E. Resistance Training as a Countermeasure in Women with Gestational Diabetes Mellitus: A Review of Current Literature and Future Directions. Sports Med 2022; 52:2871-2888. [PMID: 35810251 PMCID: PMC10043826 DOI: 10.1007/s40279-022-01724-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
Abstract
Gestational diabetes mellitus (GDM) poses a significant health concern for both mother and offspring. Exercise has emerged as a cornerstone of glycemic management in GDM. However, most research regarding this topic examines aerobic training (AT), despite substantial evidence for the effectiveness of resistance training (RT) in improving dysregulated glucose in other groups of people with diabetes, such as in type 2 diabetes mellitus (T2DM). Thus, the purpose of this paper is to review research that examined the impact of RT on markers of glucose management in GDM, and to discuss future research directions to determine the benefits of RT in GDM. Based on the current evidence, RT is effective in reducing insulin requirement, especially in overweight women, reducing fasting glucose concentrations, and improving short-term postprandial glycemic control. However, the number of studies and findings limit conclusions about the impact of RT on risk of GDM, fasting insulin concentrations, insulin resistance, β-cell function, and intra-exercise glucose management. Overall, current evidence is accumulating to suggest that RT is a promising non-pharmacological tool to regulate circulating glucose concentrations in women with GDM, and a potential alternative or supplement to AT.
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Affiliation(s)
- Brittany R Allman
- Arkansas Children's Nutrition Center, Little Rock, AR, USA.
- Arkansas Children's Research Institute, Little Rock, AR, USA.
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
| | - Samantha McDonald
- School of Kinesiology and Recreation, Illinois State University, Normal, IL, USA
| | - Linda May
- Department of Obstetrics and Gynecology, East Carolina University (ECU), Greenville, NC, USA
- Department of Kinesiology, ECU, Greenville, NC, USA
- Department of Foundational Sciences and Research, ECU, Greenville, NC, USA
| | - Elisabet Børsheim
- Arkansas Children's Nutrition Center, Little Rock, AR, USA
- Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Departments of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Exercise Intervention Improves Blood Glucose Levels and Adverse Pregnancy Outcomes in GDM Patients: A Meta-Analysis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9287737. [PMID: 36238491 PMCID: PMC9553359 DOI: 10.1155/2022/9287737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022]
Abstract
Objective The objective of this study is to systematically evaluate the effect of exercise on gestational diabetes (GDM). Methods The databases of PubMed, Cochrane Library, Web of Science, Embase, CNKI, VIP, and Wanfang were searched to collect publications regarding physical exercises and GDM. The two researchers screened the literature, extracted the data, and analyzed the risk of bias of the included data using RevMan 5.3 software. The primary outcomes analyzed included the fasting blood glucose, 2-h postprandial blood glucose, glycosylated hemoglobin, premature delivery, cesarean section, neonatal macrosomia, premature rupture of membranes, and neonatal hypoglycemia. Results A total of 9 studies with 1289 GDM patients were included. Compared with the control group, exercise could significantly reduce the 2-h postprandial blood glucose (MD = −0.62, 95% CI (-0.91 to -0.34), Z = 4.29, P < 0.0001), improve HbA1c(RR = −0.47, 95% CI (-0.81 to -0.13), Z = 2.69, P = 0.007), reduce the cesarean section rate (RR = 0.83, 95% CI (0.71-0.98), Z = 2.25, P = 0.02), and decrease the incidence of neonatal macrosomia in GDM patients (RR = 0.57, 95% CI (0.34-0.95), Z = 2.17, P = 0.03). Conclusion Exercise intervention can improve the blood glucose level of GDM patients, such as 2-h postprandial blood glucose and HbA1c. Meanwhile, exercise can also reduce adverse pregnancy outcomes, such as premature birth and macrosomia. Therefore, prescribing exercise to GDM patients can effectively manage GDM and improve adverse pregnancy outcomes.
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15
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Zhu Z, Xie H, Liu S, Yang R, Yu J, Yan Y, Wang X, Zhang Z, Yan W. Effects of physical exercise on blood pressure during pregnancy. BMC Public Health 2022; 22:1733. [PMID: 36096756 PMCID: PMC9469521 DOI: 10.1186/s12889-022-14074-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/22/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Effect of physical exercise on pregnant women currently has become a hot topic in prenatal health care. In this study, A meta-analysis was conducted on account of Randomized Controlled Trial (RCT). It focused on evaluating the effect of physical exercise intervention on blood pressure so that could provide certain evidence for health care during pregnancy. Methods Results of relevant studies were retrieved from PubMed, Embase, Web of Science and the Cochrane Library, and all of these included studies were evaluated according to the Cochrane collaboration’s tool for assessing the risk of bias. Stata 15.1 was used for meta-analysis, and mean difference (MD) was used as statistic for pooled analysis. The effect values were combined by conventional meta-analysis and Bayesian meta-analysis respectively, and the consistency of pooled results was considered as well. Results A total of 18 RCT studies were included in the quantitative analysis. The conventional meta-analysis showed differences in blood pressure between intervention group and control group (P < 0.05). Systolic and diastolic blood pressures of intervention group were 3.19 mmHg (95% CI: -5.13, -1.25) and 2.14 mmHg (95% CI: -4.26, -0.03) lower than that of control group, respectively. Bayesian meta-analysis showed that both systolic and diastolic pressure among intervention group decreased by 3.34 mmHg (95% CrI: -5.15, -1.56) and 2.14 mmHg (95% CrI: -3.79, − 0.50), respectively. Subgroup analysis supported that as long as healthy pregnant women participated in exercises, their blood pressure could be slightly regulated, while hypertension susceptible pregnant women significantly lowered blood pressure. Conclusion Exercise intervention during pregnancy is beneficial to lower or normalize blood pressure, and this research provides clues for follow-up studies.
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Affiliation(s)
- Zhu Zhu
- Jiangsu Vocational Institute of Commerce, Nanjing, 211168, China
| | - Hang Xie
- Office of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Shiping Liu
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Ruizhe Yang
- Department of Public Health, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Juan Yu
- Department of Medicine, Gansu University of Chinese Medicine, Dingxi, 743000, China
| | - Yiping Yan
- College of Mathematics and Statistics, Northwest Normal University, Lanzhou, 730070, China
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Zhihua Zhang
- Yunyang People's Hospital of Danyang, Danyang, 212300, China.
| | - Wu Yan
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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Rovcanin M, Jankovic S, Mikovic Z, Sipetic Grujicic S, Ersk IRB, Lackovic M, Dimitrijevic D, Simanic S, Vujcic I. The Translation and Cross-Cultural Adaptation of the Pregnancy Physical Activity Questionnaire: Validity and Reliability of a Serbian Version (PPAQ-SRB). Healthcare (Basel) 2022; 10:1482. [PMID: 36011143 PMCID: PMC9408768 DOI: 10.3390/healthcare10081482] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/25/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Exercise during pregnancy has a positive effect on the health of both pregnant women and their fetuses. This study aimed to translate the Pregnancy Physical Activity Questionnaire (PPAQ) into the Serbian language and assess its validity and reliability among Serbian pregnant women. The study was conducted between October 2020 and March 2021 at the Obstetrics and Gynecology Clinic (Narodni Front), in Belgrade, Serbia. The PPAQ was translated according to a standardized methodology, and its internal consistency and construct and concurrent validity were assessed. The mean PPAQ score for the total amount of physical activity was 37.72 MET-h/week-1. Exploratory factor analysis of the Serbian PPAQ identified six factors similar to the original questionnaire that explained 70.26% of the data variance. The Cronbach's alpha coefficient of the Serbian version of the PPAQ was 0.69. The two-week intraclass correlation coefficient (ICC) scores ranged from 0.768 to 0.930. We tested the evidence to assess the concurrent validity of the Serbian version of PPAQ (PPAQ-SRB) correlations with the International Physical Activity Questionnaire-long form (IPAQ-LF), and all domains of the PPAQ were significantly correlated with domains of the IPAQ-LF. The findings of our reliability and validity evaluation are consistent with those of prior studies, indicating that the PPAQ was successfully translated and implemented in the Serbian population and that its reliability was acceptable.
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Affiliation(s)
- Marija Rovcanin
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Svetlana Jankovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Zeljko Mikovic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Sandra Sipetic Grujicic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
| | - Ivana Rudic Biljic Ersk
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Milan Lackovic
- Clinical Hospital Center, Dr Dragiša Mišović, Heroja MilanaTepica 1, 11000 Belgrade, Serbia
| | - Dejan Dimitrijevic
- Clinic for Gynecology and Obstetrics, Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Sara Simanic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
| | - Isidora Vujcic
- Faculty of Medicine, University of Belgrade, Dr Subotica Starijeg 8, 11000 Belgrade, Serbia
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Visegradska 26, 11000 Belgrade, Serbia
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Todorović J, Dugalić S, Macura M, Gutić B, Milinčić M, Božić D, Stojiljković M, Sbutega-Filipović O, Gojnić M. Nutrition in pregnancy with diabetes mellitus. SANAMED 2022. [DOI: 10.5937/sanamed0-40169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The nutritional needs of diabetic pregnancies are different from normal pregnancies. Differences in nutritional recommendations can also be seen between pregnant women who are using and who are not using insulin therapy. In this literature review, recommendations for different meal proportions of carbohydrates, proteins, and fats in the diets of pregnant women with diabetes mellitus are listed. Different meal plans were also addressed in this group of patients. The role of exercise in the management of diabetes in pregnancy is undeniable and different approaches found in the literature are presented.
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