Jovanovic-Peterson L, Peterson C M
Sansum Medical Research Foundation, Santa Barbara, California 93105.
Diabetes. 1991 Dec;40 Suppl 2:179-81. doi: 10.2337/diab.40.2.s179.
The mainstay of management of the gestational diabetic woman is dietary manipulation to achieve and maintain normoglycemia. If normoglycemia cannot be sustained by diet alone, then insulin therapy is initiated. We instituted a series of studies to observe the value and safety of a cardiovascular fitness program to improve glucose tolerance in gestational diabetic women. We first evaluated the safety for pregnant women of five aerobic exercise machines by observing the effect of these different forms of exercise on uterine activity during the third trimester. We found that upper-extremity exercise produced no uterine contractions, but lower-extremity exercise tended to produce contractions. Upper-extremity exercise, in addition to dietary therapy, was then assigned to 10 gestational diabetic women who were matched for amount of glucose intolerance to 10 gestational diabetic women managed by diet alone. The mean fasting plasma glucose +/- SD after 6 wk was 4.87 +/- 0.34 mM in the diet group versus 3.89 +/- 0.37 mM in the diet-plus-exercise group. The mean postglucose challenge in the diet group was 10.40 +/- 0.16 mM versus 5.9 +/- 1.1 mM in the diet-plus-exercise group. Thus, upper-arm exercise may provide a useful treatment option for gestational diabetes and may obviate the need for insulin.
妊娠糖尿病女性的主要治疗方法是通过饮食控制来实现并维持血糖正常。如果仅靠饮食无法维持血糖正常，则开始胰岛素治疗。我们开展了一系列研究，以观察心血管健身计划对改善妊娠糖尿病女性糖耐量的价值和安全性。我们首先通过观察这些不同形式的运动在孕晚期对子宫活动的影响，评估了五种有氧运动器械对孕妇的安全性。我们发现上肢运动不会引起子宫收缩，但下肢运动往往会引起收缩。然后，除饮食治疗外，将上肢运动分配给10名妊娠糖尿病女性，这些女性的糖耐量与10名仅接受饮食管理的妊娠糖尿病女性相匹配。6周后，饮食组的平均空腹血糖±标准差为4.87±0.34毫摩尔/升，而饮食加运动组为3.89±0.37毫摩尔/升。饮食组葡萄糖耐量试验后的平均值为10.40±0.16毫摩尔/升，而饮食加运动组为5.9±1.1毫摩尔/升。因此，上臂运动可能为妊娠糖尿病提供一种有用的治疗选择，并且可能无需使用胰岛素。
