Exercise with Gestational Diabetes

Gestational diabetes (GDM) is the term used when the body cannot produce enough insulin during pregnancy. It usually happens during 24–28-week gestation if it is going to occur.(1) GDM is characterized by excess glucose in the bloodstream.  This leads to possible adverse short-term effects on mother and newborn.(2) Poor diet, increased weight, a family history of diabetes, and sedentary behavior are some risk factors for GDM development.2 Exercise is a lifestyle modification that has been shown to help with GDM prevention and management.  

General exercise recommended for pregnancy is aerobic exercise for 30 to 60 minutes 3 to 5 times per week and strength exercise 2 to 3 times per week. (1) This should be moderate exercise, where you are able to speak 1 to 2 sentences at a time. Like with any exercise, make sure to check your blood glucose levels before and after you participate in exercise if you are taking insulin. A warm-up of 5 to 10 minutes is helpful to reduce post-exercise muscle soreness for everyone. (2) Experts recommend working up to recommended levels rather than starting at recommendations, such as starting with 20-30 minutes of exercise weekly, increasing weekly as tolerated. (3)  

There are various types of exercise that pregnant women may engage in. Aerobic exercise (i.e walking, swimming, cycling, and water aerobics) has been shown to reduce the need for insulin for between 24 to 72 hours post-exercise bout.2,3 Resistance exercise training (e.g weightlifting or body weight exercises) also have shown improved glucose control.(2) Additionally, flexibility exercises make a great low impact or warm-up option. Examples of flexibility exercises include yoga and Pilates. Your local gym may have something for pregnant women to attend.(3)  

Those with GDM experience a variety of benefits with exercise during pregnancy. Mothers may experience decreased insulin dependency and lower back pain, with increased heart function.(2) Also, there is a reduced risk of pre-term birth. Babies may have improved brain function and intelligence and lower body fat.(2)  

Exercising during pregnancy is not without its risks. Generally, avoid any physical contact exercise, being in the same position for too long, and holding your breath. During the first trimester, make sure your environment is not too warm or humid.3 After the 4th month of pregnancy, avoid exercises where you lay on your back. Modify these to be on your side or standing.3 In your final trimester, avoid one-sided exercise, such as lunges.(3) Overall, if it doesn’t feel right, make sure to stop.(3) All pregnant women should participate in physical activity, regardless of format or quantity. There are numerous benefits for both the mother and child, resulting in a healthy pregnancy. 

 

References  

1. Metzger BE, Coustan DR. Summary and recommendations of the fourth international workshop- conference on gestational diabetes mellitus. In: Diabetes Care. Vol 21. ; 1998. doi:10.2337/diab.34.2.s123 

2. Padayachee C. Exercise guidelines for gestational diabetes mellitus. World Journal of Diabetes. 2015;6(8). doi:10.4239/wjd.v6.i8.1033 

3. Diabetes NSW & ACT. Safe exercise for gestational diabetes. 2021.