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运动强度和时间对低危和高危妊娠糖尿病孕妇毛细血管血糖反应的影响。

Effect of exercise intensity and duration on capillary glucose responses in pregnant women at low and high risk for gestational diabetes.

机构信息

R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Canada.

出版信息

Diabetes Metab Res Rev. 2012 Nov;28(8):669-78. doi: 10.1002/dmrr.2324.

Abstract

BACKGROUND

Exercise may influence glucose metabolism during pregnancy. We examined the effect of exercise intensity and duration on capillary glucose responses in pregnant women at low and high risk for gestational diabetes mellitus (GDM) who followed a modified GDM meal plan.

METHODS

Randomization occurred at study entry (16-20 weeks' gestation) into a low-intensity [30% heart rate reserve, low risk-30%I, n = 12; high risk-30%I, n = 11] or vigorous-intensity (70% heart rate reserve, low risk-70%I, n = 12; R-70%I, n = 11) exercise program with similar nutritional control. Exercise consisted of walking three to four times a week, gradually increasing time from 25 to 40 min/session. Free-living capillary glucose concentrations were measured once a week pre-exercise and post-exercise.

RESULTS

Capillary glucose responses to exercise were strongly influenced by an interaction between GDM risk, exercise duration and exercise intensity (p = 0.006). Decreases in glucose concentrations were observed after 25 (4 ± 13%), 35 (21 ± 12%) and 40 min (15 ± 18%) of walking in high risk-30%I women, with the most noticeable decline after 35 and 40 min. In the high risk-70%I, glucose concentrations decreased significantly only after 25 (22 ± 14%) and 35 min (7 ± 23%) and increasing the exercise time attenuated glucose concentrations decline. In low risk women, regardless of exercise intensity and duration, decreases in glucose concentrations were significant and similar.

CONCLUSION

To achieve the best decline in glucose concentrations, pregnant women who follow a modified GDM meal plan should walk for 25 min/session at vigorous intensity or for 35-40 min/session at low intensity if they are at risk for GDM and for at least 25 min at either low or vigorous intensity if they are at low risk for GDM.

摘要

背景

运动可能会影响妊娠期间的葡萄糖代谢。我们研究了在遵循改良 GDM 饮食计划的低危和高危 GDM 孕妇中,运动强度和时间对毛细血管葡萄糖反应的影响。

方法

在研究开始时(16-20 周妊娠),根据低强度[心率储备的 30%,低危-30%I,n=12;高危-30%I,n=11]或高强度(心率储备的 70%,低危-70%I,n=12;R-70%I,n=11)运动方案随机分组,同时进行类似的营养控制。运动包括每周散步三到四次,逐渐将时间从 25 分钟增加到 40 分钟/次。每周在运动前和运动后测量一次自由生活毛细血管葡萄糖浓度。

结果

毛细血管葡萄糖对运动的反应受到 GDM 风险、运动持续时间和运动强度之间的相互作用的强烈影响(p=0.006)。高危-30%I 女性在步行 25(4±13%)、35(21±12%)和 40 分钟(15±18%)后葡萄糖浓度下降,在 35 和 40 分钟后下降最明显。在高危-70%I 中,仅在步行 25(22±14%)和 35 分钟(7±23%)后葡萄糖浓度显著下降,增加运动时间会减弱葡萄糖浓度的下降。在低危女性中,无论运动强度和时间如何,葡萄糖浓度的下降都是显著且相似的。

结论

为了使葡萄糖浓度下降达到最佳效果,遵循改良 GDM 饮食计划的孕妇如果有患 GDM 的风险,应每节以高强度步行 25 分钟,或以低强度步行 35-40 分钟;如果患 GDM 的风险低,则应以低强度或高强度至少步行 25 分钟。

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