School of Allied Health, La Trobe University; Physiotherapy Department, Werribee Mercy Hospital.
School of Allied Health, La Trobe University; Northern Health.
J Physiother. 2016 Oct;62(4):188-96. doi: 10.1016/j.jphys.2016.08.003. Epub 2016 Aug 22.
Does exercise improve postprandial glycaemic control in women diagnosed with gestational diabetes mellitus?
A systematic review of randomised trials.
Pregnant women diagnosed with gestational diabetes mellitus.
Exercise, performed more than once a week, sufficient to achieve an aerobic effect or changes in muscle metabolism.
Postprandial blood glucose, fasting blood glucose, glycated haemoglobin, requirement for insulin, adverse events and adherence.
This systematic review identified eight randomised, controlled trials involving 588 participants; seven trials (544 participants) had data that were suitable for meta-analysis. Five trials scored ≥ 6 on the PEDro scale, indicating a relatively low risk of bias. Meta-analysis showed that exercise, as an adjunct to standard care, significantly improved postprandial glycaemic control (MD -0.33mmol/L, 95% CI -0.49 to -0.17) and lowered fasting blood glucose (MD -0.31 mmol/L, 95% CI -0.56 to -0.05) when compared with standard care alone, with no increase in adverse events. Effects of similar magnitude were found for aerobic and resistance exercise programs, if performed at a moderate intensity or greater, for 20 to 30minutes, three to four times per week. Meta-analysis did not show that exercise significantly reduced the requirement for insulin. All studies reported that complications or other adverse events were either similar or reduced with exercise.
Aerobic or resistance exercise, performed at a moderate intensity at least three times per week, safely helps to control postprandial blood glucose levels and other measures of glycaemic control in women diagnosed with gestational diabetes mellitus.
PROSPERO CRD42015019106. [Harrison AL, Shields N, Taylor NF, Frawley HC (2016) Exercise improves glycaemic control in women diagnosed with gestational diabetes mellitus: a systematic review.Journal of Physiotherapy62: 188-196].
运动是否能改善被诊断为妊娠期糖尿病的女性的餐后血糖控制？
系统评价随机试验。
被诊断为妊娠期糖尿病的孕妇。
运动每周进行一次以上，足以达到有氧运动效果或改变肌肉代谢。
餐后血糖、空腹血糖、糖化血红蛋白、胰岛素需求、不良事件和依从性。
这项系统评价确定了八项涉及 588 名参与者的随机对照试验；有 7 项试验（544 名参与者）的数据适合进行荟萃分析。五项试验的 PEDro 量表评分≥6，表明偏倚风险相对较低。荟萃分析显示，与单独的标准护理相比，运动作为标准护理的辅助手段，显著改善了餐后血糖控制（MD-0.33mmol/L，95%CI-0.49 至-0.17）和降低了空腹血糖（MD-0.31mmol/L，95%CI-0.56 至-0.05），且没有增加不良事件。如果运动强度适中或更大，每周进行 3 到 4 次，每次 20 到 30 分钟，那么对于有氧运动和抗阻运动方案，也发现了类似或更大的效果。荟萃分析并未表明运动显著减少胰岛素的需求。所有研究报告称，运动后并发症或其他不良事件要么相似，要么减少。
每周至少进行三次中等强度的有氧运动或抗阻运动，可以安全地帮助控制被诊断为妊娠期糖尿病的女性的餐后血糖水平和其他血糖控制指标。
PROSPERO CRD42015019106。[Harrison AL、Shields N、Taylor NF、Frawley HC（2016）运动改善妊娠期糖尿病女性的血糖控制：系统评价。物理治疗杂志 62：188-196]。
