Can exercise prevent diabetes during pregnancy?
Diet and exercise will promote a healthier lifestyle for obese, pregnant women, but it is not enough to prevent gestational diabetes, a recent study shows.
Research led by Professor Lucilla Poston at King’s College in London showed that a focus on screening and treatment for gestational diabetes is more effective than a program of healthy diet and exercise.
The study, published in The Lancet Diabetes & Endocrinology, also maintains that stricter guidelines be used for diagnosis and treatment.
Gestational diabetes is a type of diabetes that occurs only during pregnancy and is usually diagnosed around the 24th week of pregnancy.
Dale K. Weldon, MD, a gynecologist at Upper Cape Gynecology who also practiced obstetrics for many years, said she found the results of the study disappointing. In the study, researchers provided information for a healthy diet but the exercise was not aggressive, she noted
“They provided diet and exercise but the exercise was about 30 minutes per week,” said Dr. Weldon. Although the education piece was very thorough, the patients were left to their own devices for maintaining the exercise and diet plans and made only small strides, she said.
In comparison, Dr. Weldon had a small group of women in her practice who were diagnosed with gestational diabetes and would have been treated with insulin. But they were reluctant to take insulin. Instead, they chose to modify their usual high carbohydrate diet and initiated an exercise program of walking many hours daily. By making those changes, the women were able to maintain relatively normal blood sugar levels.
Dr. Weldon stressed that this is not generally a recommended way of treating gestational diabetes. Since these women were able to control their blood sugars with hours of walking and a lower carbohydrate diet, it may point to a need for more aggressive intervention such as a prescribed higher and more strenuous exercise program than described in the study.
Women who are obese are unlikely to change their eating habits when they become pregnant, Dr. Weldon said. And women with gestational diabetes often give birth to larger-than-average babies.
Children born obese are more likely to remain obese throughout their lives, said Dr. Weldon. That cycle can be broken when women become educated about diet and exercise, which is more important than the study showed, she said.