22 Jul The Role of Exercise for Gestational Diabetes
Pregnancy is a very exciting time and women want to do all they can to ensure they give birth to a healthy baby. Due to the many changes that happen during pregnancy, sometimes women are diagnosed with gestational diabetes. Accredited Exercise Physiologist, Emma Young, explains how exercise can help prevent and manage gestational diabetes.
What is Gestational Diabetes?
You may have previously heard of diabetes but what is gestational diabetes? Gestational diabetes is a form of diabetes that is diagnosed whilst a woman is pregnant. To be diagnosed with gestational diabetes, elevated blood glucose levels will first appear during this time and will then return to normal levels post pregnancy. To determine if you have elevated blood glucose levels you will undergo what is called an Oral Glucose Tolerance Test at 24-28 weeks gestation.
During pregnancy the body goes into a natural diabetogenic or diabetes producing state due to the changes in hormones. This can impact glucose tolerance and insulin sensitivity. The circulating pregnancy hormones increase resistance in the peripheral muscles of the mother therefore increasing blood glucose levels. This is to allow enough glucose to be delivered to your baby, which is needed for proper development. However, it is important that these blood glucose levels do not get too high.
What are the concerns and consequences associated with Gestational Diabetes?
Gestational diabetes can lead to the mother developing preeclampsia or high blood pressure during pregnancy followed by complications during birth. For the child, gestational diabetes can increase birth weight and hypoglycaemia or low blood glucose levels.
Gestational diabetes can also have a long-term impact on the mother and child’s health. For the mother, there is an increased risk of developing type 2 diabetes mellitus and developing gestational diabetes in future pregnancies. For the child, they have an increased risk of developing type 2 diabetes mellitus and if the child is female, gestational diabetes if they become pregnant. They also have an increased risk of obesity and cardiac conditions.
What are the risk factors for developing Gestational Diabetes?
- Gestational diabetes in a previous pregnancy
- Pre diabetic before pregnancy
- Ethnicity – Indigenous Australians, Torres Strait Islanders, Indian, Chinese, Vietnamese, Middle Eastern, Polynesian and Melanesian women
- Maternal age >25 with further risk at maternal age >35
- Family history of type 2 diabetes mellitus
- Your mother had gestational diabetes
- Overweight or obese
- Physical inactivity
- Poor nutrition
- Previous child with a high birth weight (>4.5kg)
- Polycystic ovarian syndrome
- Medications that increase insulin resistance
How can exercise help with Gestational Diabetes?
Exercise is important for every expectant mother. However it is especially important for those at risk of developing gestational diabetes and those who have been diagnosed with gestational diabetes.
If you are thinking about becoming pregnant, exercising beforehand has been shown to have a greater beneficial effect on preventing gestational diabetes than starting once you become pregnant. However, do not let this stop you from beginning exercise if you are already pregnant. Completing structured physical activity once pregnant still has a great impact on reducing gestational diabetes risk. Both aerobic and strength training have been shown to have positive benefits in risk reduction for gestational diabetes.
If you have already been diagnosed with gestational diabetes, then exercise as an adjunct to usual care has been shown to greatly improve postprandial glycaemic control or your blood glucose post meal consumption as well as lowering fasting blood glucose levels. This is in comparison to standard care alone. Aerobic training in particular can help with reducing insulin use and dose, postprandial glucose levels, HbA1c levels, birth weight and gestational weight gain. Resistance training in particular can aid in reducing insulin onset and dose as well as postprandial glucose levels.
What type of exercise is recommended for those with Gestational Diabetes?
The exercise recommendations for those with gestational diabetes are aligned with the general recommendations for women who are pregnant. This involves completing 30 minutes of aerobic exercise on 3-5 days totaling 150 minutes a week at moderate intensity. Some examples of aerobic exercise include:
- Stationary or recumbent bike
- Arm bike
The resistance training recommendations are 1-3 sets depending on exercise experience and 8-15 repetitions at a moderate intensity. Resistance training should be completed on 2-3 non-consecutive days per week. Some examples of resistance exercises include using:
- Machine weights
- Free weights
- Body weight
The recommendations also suggest completing flexibility training on at least 2-3 days per week. Stretch to the point slight tightness and hold for 10-30 seconds.
What are the safety precautions of exercising with Gestational Diabetes?
It is important to note that exercise has been found to be very safe for women with gestational diabetes. Studies show a low incidence of adverse events such as hypoglycaemia, also known as low blood glucose levels occurring during exercise training. However, the general safety precautions of exercising whilst pregnant still remain. These include:
- Avoid contact sport
- Avoid lying on your back after the 1st trimester
- Avoid exercising in heated pools and hot environments
- Avoid exercises where you may lose balance
Get the “right” advice
It’s important to seek clearance and guidance from your doctor before you begin exercising. If you have not been previously active then begin small and progress as able. Your aerobic exercise does not have to be completed all at once. You may start with 3 lots of 10 minute bouts.
The exercise recommendations may be different for you if you have other health conditions. If you have any concerns about exercising whilst you are pregnant then seeing an Accredited Exercise Physiologist may be the right step for you. They will be able to educate and tailor a program around your specific health concerns and goals.
There’s over 6,500 Accredited Exercise Professionals around Australia who can help you to “exercise right” for your individual needs during pregnancy. Click here to find one near you!
Written by Emma Young. Emma is an Accredited Exercise Physiologist at Inform Health and Exercise. Emma has completed her Masters of Clinical Exercise Physiology and a Bachelor of Exercise Science/ Bachelor of Business Administration at Australian Catholic University.
Emma is passionate about helping clients accomplish their goals in a safe and supportive environment through the use of evidence based practice. She truly enjoys getting to know her clients so they can achieve the best possible results.