Boulvain Michel, Othenin-Girard Véronique, Jornayvaz François R, Kayser Bengt
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.
Diabetol Metab Syndr. 2024 Sep 30;16(1):238. doi: 10.1186/s13098-024-01470-1.
To assess the effectiveness of an exercise intervention, in addition to standard care, in preventing or delaying insulin prescription in women with gestational diabetes mellitus (GDM).
Randomised controlled trial.
University hospital.
Pregnant women at 25-35 weeks of gestation diagnosed with GDM.
Women in the intervention group participated in weekly, supervised, 30-45 min exercise sessions and were encouraged to accumulate more than 5000 steps per day, tracked by a pedometer, in addition to receiving usual care. The control group received standard care only.
Insulin prescription.
From February 2008 through April 2013, 109 women were randomized into the intervention group (n = 57) or the usual care group (n = 52). Two women in the intervention group were excluded from the analysis (one was randomised in error and one was lost to follow-up). Six women never attended the exercise sessions, and two attended fewer than two sessions. However, two-third of women were considered as compliant to the intervention (attended more than 50% of sessions and/or averaged more than 5000 steps/day). The incidence of insulin prescription did not differ between the groups: 31 women (56%) in the intervention group versus 24 women (46%) in the control group (RR 1.22, 95% CI 0.84 to 1.78). The median time from randomization to insulin prescription was also similar between groups (14 days in the intervention group and 13 days in the control group).
This study did not demonstrate that an exercise program reduces or delays insulin prescription in women with GDM. Low adherence to the intervention, a small sample size, and the short duration of the program may explain the lack of observed benefit.
At clinicaltrials.gov, NCT03174340, 02/06/2017.
评估除标准护理外，运动干预对预防或延缓妊娠期糖尿病（GDM）女性使用胰岛素的有效性。
随机对照试验。
大学医院。
妊娠25 - 35周被诊断为GDM的孕妇。
干预组女性除接受常规护理外，每周参加一次由专人监督的30 - 45分钟运动课程，并鼓励她们每天通过计步器记录步数超过5000步。对照组仅接受标准护理。
胰岛素处方。
从2008年2月至2013年4月，109名女性被随机分为干预组（n = 57）或常规护理组（n = 52）。干预组有两名女性被排除在分析之外（一名随机分组错误，一名失访）。六名女性从未参加运动课程，两名女性参加课程少于两次。然而，三分之二的女性被认为依从干预（参加超过50%的课程和/或平均每天步数超过5000步）。两组间胰岛素处方的发生率无差异：干预组31名女性（56%），对照组24名女性（46%）（相对危险度1.22，95%置信区间0.84至1.78）。两组从随机分组到开具胰岛素处方的中位时间也相似（干预组14天，对照组13天）。
本研究未证明运动计划能减少或延缓GDM女性使用胰岛素。对干预的低依从性、小样本量和该计划的短持续时间可能解释了未观察到益处的原因。
在clinicaltrials.gov注册，NCT03174340，2017年6月2日。
