餐后间隔步行对妊娠期糖尿病孕妇血糖的影响。

Postprandial interval walking-effect on blood glucose in pregnant women with gestational diabetes.

机构信息

Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Am J Obstet Gynecol MFM. 2021 Nov;3(6):100440. doi: 10.1016/j.ajogmf.2021.100440. Epub 2021 Jun 30.

DOI:10.1016/j.ajogmf.2021.100440

PMID:34216833

Abstract

BACKGROUND

During pregnancy, postprandial hyperglycemia may increase the risk of complications such as fetal macrosomia. However, evidence on beneficial effects of physical activity on postprandial hyperglycemia is sparse.

OBJECTIVE

This study aimed to investigate the effect of 20 minutes of postprandial interval walking on glycemic control and glycemic variability in pregnant women diagnosed as having gestational diabetes mellitus.

STUDY DESIGN

A crossover controlled trial including 14 pregnant women (gestational age 31.8±1.3 weeks) diagnosed as having gestational diabetes mellitus (75 g oral glucose load with 2-hour venous plasma glucose of ≥9.0 mmol/L) was conducted. Participants completed a 4-day intervention period and a 4-day control period with 3 days in between. In each study period, participants received a fixed and identical diet. In the intervention period, participants engaged in 20 minutes of postprandial interval walking after breakfast, lunch, and dinner. Interval walking comprised alternating 3 minutes of slow and fast intervals. Interstitial glucose concentrations were determined during both study periods with a continuous glucose monitor. The mixed effects model was used to compare differences between exercise and no exercise.

RESULTS

Of note, 20 minutes of postprandial interval walking significantly reduced glycemic control during daytime hours relative to the control period (4-day mean glucose, 5.31 [5.04-5.59] vs 5.53 [5.25-5.81] mmol/L [95.6 (90.7-100.6) vs 99.5 (94.5-104.6) mg/dL]; P<.05). On each individual trial day, interval walking significantly reduced glycemic control during daytime hours on day 1 (mean glucose, 5.19 [4.92-5.47] vs 5.55 [5.27-5.83] mmol/L [93.4 (88.6-98.5) vs 99.9 (94.9-104.9) mg/dL]; P=.00), day 2 (mean glucose, 5.32 [5.05-5.60] vs 5.57 [5.29-5.84] mmol/L [95.8 (90.9-100.8) vs 100.3 (95.2-105.1) mg/dL]; P=.00), and day 3 (mean glucose, 5.27 [5.00-5.54] vs 5.46 [5.19-5.74] mmol/L [94.9 (90.0-99.7) vs 98.3 (93.4-103.3) mg/dL]; P=.00), but not on day 4.

CONCLUSION

A total of 20 minutes of postprandial interval walking seems to be an effective way to control postprandial glucose excursions in women with gestational diabetes mellitus.

摘要

背景

孕期餐后高血糖可能会增加胎儿巨大儿等并发症的风险。然而，关于体力活动对餐后高血糖有益影响的证据还很稀少。

目的

本研究旨在探讨餐后 20 分钟间隔散步对诊断为妊娠期糖尿病的孕妇血糖控制和血糖变异性的影响。

研究设计

这是一项交叉对照试验，纳入了 14 名（妊娠龄 31.8±1.3 周）被诊断为妊娠期糖尿病的孕妇（75g 口服葡萄糖负荷后 2 小时静脉血浆葡萄糖≥9.0mmol/L）。参与者完成了 4 天的干预期和 4 天的对照期，中间间隔 3 天。在每个研究期间，参与者都接受了相同的固定饮食。在干预期间，参与者在早餐、午餐和晚餐后进行 20 分钟的餐后间隔散步。间隔散步包括 3 分钟的慢步和快步交替进行。在两个研究期间，都使用连续血糖监测仪来测定间质葡萄糖浓度。采用混合效应模型比较运动和不运动之间的差异。

结果

值得注意的是，与对照期相比，20 分钟的餐后间隔散步显著降低了白天的血糖控制（4 天平均血糖，5.31[5.04-5.59] vs 5.53[5.25-5.81]mmol/L[95.6(90.7-100.6) vs 99.5(94.5-104.6)mg/dL]；P<.05）。在每个单独的试验日，间隔散步在第 1 天白天显著降低了血糖控制（平均血糖，5.19[4.92-5.47] vs 5.55[5.27-5.83]mmol/L[93.4(88.6-98.5) vs 99.9(94.9-104.9)mg/dL]；P=.00）、第 2 天（平均血糖，5.32[5.05-5.60] vs 5.57[5.29-5.84]mmol/L[95.8(90.9-100.8) vs 100.3(95.2-105.1)mg/dL]；P=.00）和第 3 天（平均血糖，5.27[5.00-5.54] vs 5.46[5.19-5.74]mmol/L[94.9(90.0-99.7) vs 98.3(93.4-103.3)mg/dL]；P=.00），但在第 4 天没有。