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Daily walking improves glycemic profile in women with gestational diabetes
Women with gestational diabetes who walked at least 6,000 steps per day for 7 to 12 weeks had a lower casual glucose level in their second trimester vs. pregnant women who walked fewer than 6,000 steps per day, according to findings from a small longitudinal study conducted in Japan.
“Although dietary and physical treatments may be effective for gestational diabetes, general physical treatment seems to be hard for pregnant women because of their physical condition,” Nobuhiko Suganuma, MD, PhD, professor emeritus at Kyoto University and professor in the department of nursing at Nagoya University of Arts and Sciences, told Endocrine Today. “Thus, dietary control is mainly prescribed for women with gestational diabetes. However, light-intensity exercise, such as walking, can be acceptable even for pregnant women.”
In the longitudinal study, Suganuma and colleagues analyzed data from 24 women with gestational diabetes diagnosed during their second trimester of pregnancy who received care at Toyota Memorial Hospital, Japan, between 2015 and June 2016 (mean age, 36 years; mean prepregnancy BMI, 24.1 kg/m²). Diagnosis of gestational diabetes was based on a blood glucose measurement of at least 92 mg/dL at fasting, at least 180 mg/dL at 60 minutes after loading or at least 153 mg/dL at 120 minutes after loading.
Participants completed questionnaires to evaluate dietary intake, and researchers reviewed patient charts for information about maternal age, gestational week, prepregnancy BMI, pregnancy history, fetus number, pregnancy complications and laboratory biochemical data.
The researchers estimated the total amount of daily walking based on the number of steps taken and the amount of daily exercise as measured with an accelerometer attached to the participants’ waistbands for walking for 7 to 12 weeks. The accelerometer evaluated daily walking in terms of steps, physical activity-related intensity, and physical activity-related energy expenditure.
Researchers assessed casual glucose level and HbA1c at baseline and again at the end of the study to estimate pre- and post-research carbohydrate metabolism.
The following mean values for age were determined: prepregnancy BMI: 35.9 kg/m2 (range, 29-42); gestational weeks at the start of the study: 24.1 weeks (range, 16.7-36.8); gestational age at completion of the study: 21.9 weeks (range, 14-27); and duration of walking measurements: 8.6 weeks (range, 7-12).
Within the cohort, the number of mean daily steps taken was 5,922 steps, ranging from 2,947 to 9,205, during a mean of 8.6 weeks, according to researchers. The mean casual glucose level on the first and last day of walking measurements were 107 mg/dL and 104 mg/dL, respectively, with 13 women experiencing a decrease in casual glucose level during the intervention period. Researchers observed a positive correlation (r = 0.798; P = .000) between the number of steps taken and physical activity-related energy expenditure, suggesting that daily walking consumes sufficient energy as physical activity, even in pregnant women, the researchers wrote.
The ratio of casual glucose level changes (completed/initiated) ranged from 0.54 to 1.67, whereas the ratio of HbA1c changes ranged from 0.83 to 1.1, according to researchers, who also noted a negative association between the number of steps walked daily and ratio of casual glucose level changes. Conversely, the numbers of steps walked daily did not show any clear association (r = –0.071; P = .755). There was no association between casual glucose level ratio and weight gain (r = .338; P = .124).
Dietary intake as assessed by a brief diet history questionnaire ranged from 1,125 kcal and 2,761 kcal per day. There was no statistically significant correlation between the number of daily steps and daily caloric intake, or the individual intakes of carbohydrates, protein and fat.
“The number of walking steps evaluated by accelerometer correlated to the ratio of post- to pre-research casual glucose level significantly, which means physical activity such as daily walking could improve glucose tolerance for women with gestational diabetes in the second trimester,” Suganuma said. “For pregnant women with and without gestational diabetes, the physician can recommend walking as a light activity, prescribing at least 6,000 steps per day.” – by Jennifer Byrne
For more information:
Nobuhiko S uganuma , MD, PhD , can be reached at Nagoya University of Arts and Sciences, 4-1-1, Sannomaru, Naka-ku, Nagoya 460-0001, Japan; email: suganobu@nuas.ac.jp.
Disclosures: The authors report no relevant financial disclosures.