Exercise and gestational diabetes

Gestational diabetes (GD) is a condition in pregnancy that is rising in incidence. And left unmanaged can have some not-so-great ramifications on mum and bub.

We have discussed how diet is implicated in gestational diabetes; particularly when eating mostly refined, highly processed grains, oils, meats, and sugars, rather than their whole food forms and a lot of veg!

What we eat can influence insulin release and activity. In GD, a low glycaemic index (GI) diet is particularly powerful, being found to have a positive impact on baby birth weight and mum’s insulin activity. And so can exercise!

Exercise and gestational diabetes

Increased muscle mass can enhance insulin sensitivity.^1-4 Therefore it is important to get some walking, lunging and arm curling into your life!

And a recently released study suggests just that.

Researchers from the Norwegian University of Science and Technology monitored the effects of regular exercise in 91 obese, pregnant women, including the development of GD, in a randomised control trial.⁵

Split into two groups – an exercise and a control – the exercise group undertook supervised training 3x per week moderate treadmill walking for 35 minutes and strength training for 25 minutes, whilst the control was given standard prenatal care.

With 11 women in total developing GD throughout the course of their pregnancy, those in the exercise group (n=2) were less likely to develop GD compared with those in the control (n=9). And whilst weight loss wasn’t apparent, blood pressure was reduced in the exercise group too – brilliant!

This supports older research encouraging movement and muscle strengthening prior to and throughout pregnancy. And it seems the more exercise one gets, the less the likelihood that GD, and associated issues, will develop.^6;7

So why is it we need to worry about GD?

Gestational diabetes 101

In pregnancy, the placenta produces a hormone that blocks the release of insulin. This is despite the pancreas working overtime to get insulin into the blood to deal with any glucose floating about.

The excess glucose can move through the placenta and into the baby’s space. The baby’s pancreas then kicks into gear, producing insulin to contend with all this glucose. So even before birth there is high activity by the baby’s pancreatic beta cells, followed with any excess glucose being tucked away as fat.

And the baby can be born big. This leads to increased risk for caesarean delivery, perineal tear, or damage to the bub’s shoulders during birth, as well as respiratory problems, obesity and type 2 diabetes later on in life.^8;9

Additionally, mum can experience higher blood pressure and increased risk for pre-eclampsia. Not ideal!

Get moving

So, there is plenty of reason to take charge of what you eat and how you move when pregnant, or planning, to avoid GD development.

We will always recommend you chat with your trusted, qualified healthcare professional – like a mid-wife, nurse, obstetrician, nutritionist or dietician – to work with you to create an individualised treatment plan.

And a critical part of any plan to prevent and manage GD should include exercise!

Aim for 15-30 minutes a day, or 1 hour 3x per week, and include a mixture of brisk walking with some kind of strength or resistance training, like gentle weights, swimming, pilates or yoga. And if you can’t quite reach these targets, just know that according to study authors even a little makes a positive difference!⁵

So grab a mate or your dog and head to the park; pump those soup cans or strike a supported triangle pose! Enjoy the opportunity to get moving, strong and sensitive to insulin.

By Angela Johnson (BHSc Nut. Med.)

References:

1. Dubé, JJ Fleishman, K Rousson, V Goodpaster, BH & Amati, F 2012 ‘Exercise Dose and Insulin Sensitivity: Relevance for Diabetes Prevention’, Medicine and Science in Sports and Exercise, vol. 44, 5, pp. 793–799.
2. Lee, S, Bacha, F, Hannon, T, Kuk, JL, Boesch, C, & Arslanian, S 2012, ‘Effects of aerobic versus resistance exercise without caloric restriction on abdominal fat, intrahepatic lipid, and insulin sensitivity in obese adolescent boys: a randomized, controlled trial’, Diabetes, vol. 61, no. 11, pp. 2787-2795.
3. Liu, X, Niu, Y, Yuan, H, Huang, J, & Fu, L 2015, ‘Basic Science: AMPK binds to Sestrins and mediates the effect of exercise to increase insulin-sensitivity through autophagy’, Metabolism, vol. 64, pp. 658-665.
4. Zierath, JR 2002, ‘Invited Review: Exercise training-induced changes in insulin signaling in skeletal muscle’, Journal of Applied Physiology, 93, vol. 2, pp. 773-781.
5. Garnæs, KK, Mørkved, S, Salvesen, Ø, & Moholdt, T 2016, ‘Exercise Training and Weight Gain in Obese Pregnant Women: A Randomized Controlled Trial (ETIP Trial)’, PLoS Medicine, vol. 13, no. 7, pp. 1-18.
6. Brankston, GN, Mitchell, B, Ryan, EA, & Okun, NB 2004, ‘Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus’, American Journal of Obstetrics and Gynecology, vol. 190, pp. 188-193.
7. Weissgerber, TL, Wolfe, LA, Davies, GA, & Mottola, MF 2006, ‘Exercise in the prevention and treatment of maternal–fetal disease: a review of the literature’, Applied Physiology, Nutrition & Metabolism, vol. 31, no. 6, pp. 661-674.
8. American Diabetes Associations 2014, ‘What is Gestational Diabetes’, viewed 1 August 2016, <http://www.diabetes.org/diabetes-basics/gestational/what-is-gestational-diabetes.html>
9. Logan, KM, Emsley, RJ, Jeffries, S, Andrzejewska, I, Hyde, MJ, Gale, C, Chappell, K, Mandalia, S, Santhakumaran, S, Parkinson, JC, Mills, L, & Modi, N 2016, ‘Development of Early Adiposity in Infants of Mothers With Gestational Diabetes Mellitus’, Diabetes Care.