Altemani Abdullah H, Alzaheb Riyadh A
Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia.
Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia.
Diabetol Metab Syndr. 2022 Jun 15;14(1):83. doi: 10.1186/s13098-022-00854-5.
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy. The disease is on the rise worldwide with deleterious consequences on the fetus, mother, and children. The study aimed to review the role of lifestyle in the prevention of GDM. We searched PubMed, SCOPUS, Web of Science, Cochrane Library, EBSCO, and Google Scholar from the first published article up to December 2021; articles were eligible if they were controlled trials, prospective cohorts, and case-control. Out of 5559 articles retrieved, 66 full texts were screened, and 19 studies were included in the meta-analysis. (6 studies assessed the effects of diet, and 13 were on exercise). The dietary intervention showed significant positive effect on GDM, odd ratio = 0.69, 95% CI, 0.56-84, P-value for overall effect = 0.002. The DASH diet was better than Mediterranean Diet (odd ratio, 0.71, 95% CI, 68-74, P-value < 0.001). Regarding exercise, no significant prevention was evident on GDM, odd ratio, 0.77, 95% CI, 0.55-1.06, P-value = 0.11. However, a significant prevention of gestational diabetes was found when the exercise was mild-moderate (odd ratio = 0.65, 95% CI, 0.53-80, P < 0.0001) and started in the first trimester (odd ratio, 0.57, 95% CI, 0.43-0.75, P < 0.0001. No significant effect was found when the exercise was vigorous (odd ratio = 1.09, 95% CI, 0.50-2.38, P = 0.83) and started during the second trimester of pregnancy (odd ratio, 1.08, 95% CI, 0.65-1.80, P = 0.77. Diet and early mild-moderate exercise were effective in GDM prevention. Exercise during the second trimester and moderate-vigorous were not. Further studies assessing the type, duration, and frequency of physical activity are needed.
妊娠期糖尿病（GDM）是妊娠最常见的并发症。该疾病在全球范围内呈上升趋势，对胎儿、母亲和儿童都会产生有害影响。本研究旨在综述生活方式在预防GDM中的作用。我们检索了PubMed、SCOPUS、科学网、考克兰图书馆、EBSCO和谷歌学术，检索时间从第一篇发表的文章至2021年12月；纳入标准为对照试验、前瞻性队列研究和病例对照研究。在检索到的5559篇文章中，筛选了66篇全文，19项研究纳入荟萃分析。（6项研究评估饮食的影响，13项研究关注运动）。饮食干预对GDM有显著的积极影响，比值比=0.69，95%置信区间为0.56 - 84，总体效应的P值=0.002。得舒饮食（DASH饮食）优于地中海饮食（比值比为0.71，95%置信区间为68 - 74，P值<0.001）。关于运动，对GDM没有明显的预防作用，比值比为0.77，95%置信区间为0.55 - 1.06，P值=0.11。然而，当运动为轻度至中度时（比值比=0.65，95%置信区间为0.53 - 80，P<0.0001）且在孕早期开始时（比值比为0.57，95%置信区间为0.43 - 0.75，P<0.0001），对妊娠期糖尿病有显著的预防作用。当运动为剧烈运动时（比值比=1.09，95%置信区间为0.50 - 2.38，P=0.83）以及在妊娠中期开始时（比值比为1.08，95%置信区间为0.65 - 1.80，P=0.77），未发现显著效果。饮食和孕早期轻度至中度运动对预防GDM有效。妊娠中期运动以及中度至剧烈运动则无效。需要进一步研究评估体育活动的类型、持续时间和频率。
