Bo S, Rosato R, Ciccone G, Canil S, Gambino R, Poala C B, Leone F, Valla A, Grassi G, Ghigo E, Cassader M, Menato G
Department of Medical Sciences, University of Turin, Turin, Italy.
Diabetes Obes Metab. 2014 Oct;16(10):1032-5. doi: 10.1111/dom.12289. Epub 2014 Apr 7.
The benefits of exercise and behavioural recommendations in gestational diabetes mellitus (GDM) are controversial. In a randomized trial with a 2 × 2 factorial design, we examined the effect of exercise and behavioural recommendations on metabolic variables, and maternal/neonatal outcomes in 200 GDM patients. All women were given the same diet: group D received dietary recommendations only; group E was advised to briskly walk 20-min/day; group B received behavioural dietary recommendations; group BE was prescribed the same as B + E. Dietary habits improved in all groups. In a multivariable regression model, fasting glucose did not change. Exercise, but not behavioural recommendations, was associated with the reduction of postprandial glucose (p < 0001), glycated haemoglobin (HbA1c; p < 0.001), triglycerides (p = 0.02) and C-reactive protein (CRP; p < 0.001) and reduced any maternal/neonatal complications (OR = 0.50; 95%CI=0.28-0.89;p = 0.02). In GDM patients a simple exercise programme reduced maternal postprandial glucose, HbA1c, CRP, triglycerides and any maternal/neonatal complications, but not fasting glucose values.
运动和行为建议对妊娠期糖尿病（GDM）的益处存在争议。在一项采用2×2析因设计的随机试验中，我们研究了运动和行为建议对200例GDM患者代谢变量以及母婴结局的影响。所有女性均采用相同饮食：D组仅接受饮食建议；E组被建议每天轻快步行20分钟；B组接受行为饮食建议；BE组的方案与B组加E组相同。所有组的饮食习惯均有所改善。在多变量回归模型中，空腹血糖未发生变化。运动而非行为建议与餐后血糖降低（p<0.001）、糖化血红蛋白（HbA1c；p<0.001）、甘油三酯（p=0.02）和C反应蛋白（CRP；p<0.001）相关，并减少了任何母婴并发症（OR=0.50；95%CI=0.28-0.89；p=0.02）。在GDM患者中，一个简单的运动方案可降低母体餐后血糖、HbA1c、CRP、甘油三酯以及任何母婴并发症，但不能降低空腹血糖值。
