Onaade Oluwafemifola, Maples Jill M, Rand Bethany, Fortner Kimberly B, Zite Nikki B, Ehrlich Samantha F
Department of Public Health, The University of Tennessee, 369 HPER, 1914 Andy Holt Ave., TN, 37996, Knoxville, USA.
Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tennessee, Knoxville, TN, USA.
Clin Diabetes Endocrinol. 2021 Apr 25;7(1):7. doi: 10.1186/s40842-021-00120-z.
Gestational Diabetes Mellitus (GDM) is associated with adverse health outcomes during pregnancy and beyond. Previous randomized controlled trials of exercise interventions have demonstrated that exercise, conducted primarily during supervised sessions, improves maternal glycemic control in women with GDM. However, additional research is needed to develop physical activity interventions that are easily implemented in healthcare settings (e.g., recommendations and strategies to increase non-supervised physical activity). This narrative review presents: current physical activity recommendations for pregnancy and women with GDM; the scientific literature to date on physical activity, particularly walking, and blood glucose control in GDM; rationale for physical activity interventions targeting women with GDM that are appropriate for translation to the clinical setting (e.g., lifestyle interventions that include behavioral counseling with a health coach); and the strategies employed by previous, successful lifestyle interventions for pregnant and postpartum women that were based in clinical settings.Most previous exercise interventions for blood glucose control in women with GDM have included supervised exercise sessions, and will thus be difficult to translate to the health care system. However, lifestyle interventions for weight maintenance (i.e., healthy diet and physical activity) set in the health care system and delivered by health coaches have been successfully implemented in pregnant and postpartum populations. Therefore, we suggest that future trials examine lifestyle interventions that promote unsupervised walking with evidence-based behavioral strategies (e.g., goal setting, monitoring, and feedback) and consider incorporating the use of physical activity tracking devices to support these strategies.
妊娠期糖尿病（GDM）与孕期及产后的不良健康结局相关。先前关于运动干预的随机对照试验表明，主要在有监督的情况下进行的运动可改善GDM女性的母体血糖控制。然而，需要进一步研究以开发易于在医疗环境中实施的身体活动干预措施（例如，增加无监督身体活动的建议和策略）。本叙述性综述介绍了：当前针对孕期和GDM女性的身体活动建议；迄今为止关于身体活动，特别是步行，与GDM患者血糖控制的科学文献；针对GDM女性的身体活动干预措施的基本原理，这些措施适合转化到临床环境（例如，包括与健康教练进行行为咨询的生活方式干预）；以及先前在临床环境中成功实施的针对孕妇和产后妇女的生活方式干预措施所采用的策略。
先前大多数针对GDM女性血糖控制的运动干预都包括有监督的运动课程，因此难以转化到医疗保健系统。然而，在医疗保健系统中由健康教练提供的用于维持体重的生活方式干预（即健康饮食和身体活动）已在孕妇和产后人群中成功实施。因此，我们建议未来的试验研究采用基于证据的行为策略（例如，设定目标、监测和反馈）来促进无监督步行的生活方式干预措施，并考虑使用身体活动追踪设备来支持这些策略。
