The Role of Exercise in Improving Gestational Diabetes Outcomes
By Adeline Jasinski
Gestational diabetes affects as many as 1 in 10 pregnancies in the US and can have negative consequences for both the parent and the baby. Proper exercise may help you prevent or manage your gestational diabetes.
According to the Centers for Disease Control and Prevention (CDC), gestational diabetes affects between 2% and 10% of pregnancies. It’s a common diagnosis, but just because it’s common does not mean that it’s not scary. If you were recently diagnosed with gestational diabetes, you may have questions about why you developed it, how you can manage it, and how it will affect you and your baby.
What is gestational diabetes?
During pregnancy, the placenta releases hormones to support the pregnancy. In some people, these hormones make the body’s cells temporarily resistant to insulin, leading to gestational diabetes. In this way, pregnancy causes gestational diabetes, meaning that those who develop it did not have any type of diabetes before becoming pregnant.
Normally, insulin helps most cells of the body open to let glucose in. When the cells become resistant to insulin such as during pregnancy and the pancreas cannot supply enough insulin, too much sugar stays in the bloodstream, resulting in high blood glucose levels. But who is most at risk for developing gestational diabetes?
Risk factors for developing gestational diabetes
Certain factors can put you at higher risk for developing gestational diabetes. You are more likely to develop gestational diabetes if you:
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Have obesity or excess weight
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Do not get the proper nutrition
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Are deficient in micronutrients such as Vitamin D, A, iron, zinc, folate, and iodine
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Are at advanced maternal age
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Have a family history of type 2 diabetes
Some of these factors, such as your age and family history, are out of your control. But you can always work on your diet and exercise habits. By taking steps to maintain a healthy weight, exercise, and get the right nutrition, you can reduce your risk of gestational diabetes. In doing so, you reduce your own risk of future illness as well as the risk for your future children.
It can be easier to talk about maintaining a healthy weight and eating right than to do it. If eating healthy foods and exercising are not habits for you, you might not know where to start. You will find some actionable tips below, but you should also talk to your healthcare provider before starting a new exercise program or making major changes to your diet.
Gestational diabetes puts you and your child at risk
For many people, gestational diabetes goes away after delivery. However, it can affect your future health and the health of your baby. That is why it is so important to prevent gestational diabetes from developing .
If you do develop this condition, it is critical that you carefully manage it during the pregnancy and take action after pregnancy to try to avoid future health problems.
Women who develop gestational diabetes have a high risk of developing type 2 diabetes and cardiovascular disease later in life. Gestational diabetes can also have a long-term impact on the baby’s health, too. Children whose parents had gestational diabetes are more likely to have obesity or excess weight. They are also more likely to have poor metabolic health, including greater insulin resistance, impaired glucose tolerance, type 2 diabetes, and low insulin secretion.
However, if you currently have gestational diabetes, do not feel discouraged. New research shows that changes in maternal behavior can positively impact children’s health. Children of parents with obesity who received treatment for gestational diabetes had better childhood BMI outcomes than children of those who declined treatment for gestational diabetes.
Treatment of Gestational diabetes
Lifestyle behavior change (including exercise and a prescribed diet) is an essential component of management of gestational diabetes and may suffice for many women. Insulin should be added if needed to achieve glycemic targets. Insulin is the preferred medication for treating high blood sugars in gestational diabetes mellitus.
Can exercise help manage or even prevent gestational diabetes?
Physical activity reduces blood glucose levels. Exercise causes muscle cells to increases glucose consumption. It also makes muscle cells more sensitive to insulin, which means they continue to take up glucose after exercise. Through these two mechanisms, exercise can help you manage your glucose levels.
If exercise helps manage blood glucose levels, it makes sense that exercise might also help prevent gestational diabetes. Several researchers have asked this question and found that physical activity can do just that.
One recent analysis looked at over 40 studies that followed more than 16,000 women to see which methods work best for preventing gestational diabetes. This analysis found that regular physical activity and a dietary intervention were beneficial in preventing gestational diabetes, although it did not specify which type of activity is best.
Another study went further and examined whether resistance exercise effectively mitigates symptoms of gestational diabetes. In resistance exercise, large muscle groups contract to overcome an external resistance, such as weights.
This study followed 99 women with gestational diabetes. These women were provided online education tools as well as personal dietary guidance from nutritionists and nurses. Half the women received only dietary training while the other half also completed a six-week resistance training program.
The women who went through the resistance training program performed moderate resistance activities three times a week under the supervision of a nutritionist, sports medicine expert, and the researcher. The women improved their gestational diabetes outcomes according to several measures:
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Lower fasting blood glucose levels
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Lower postprandial blood glucose levels (post-meal levels)
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Lower rates of insulin use
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Reduced blood pressure
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Reduced weight gain during pregnancy
How to incorporate resistance training into your routine
Incorporating physical activity into your routine can help you control your blood glucose levels and prevent or manage gestational diabetes. April Semon, Public Health Nutritionist with the New York State Department of Health, said, “Moderate physical activity is important for pregnant women but especially for women who have gestational diabetes. Moderate physical exercise can help insulin work better in the body and improve blood glucose levels.”
Semon added that any activity will help, but resistance training is a good option for those with gestational diabetes and for pregnant people in general. She described that in the second and third trimesters of pregnancy, people experience a forward shift in their center of gravity because of the growing fetus, which can make aerobic activity challenging. Resistance training is stable, which may make it easier and more comfortable. Even people on bedrest can perform resistance activities.
Your routine should target your major muscle groups, although you can spread the work out over multiple days. For example, you might target the upper body on one day, and the lower body on another. Here are some suggested resistance exercises (with descriptions) to do during pregnancy:
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Chest and shoulders: chest press and lateral raise
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Back: seated row
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Arms: dumbbell row and triceps kickback
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Legs: dumbbell squat, cable back kick, and standing calf raise
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Core: plank, bird dog, and side bridge
When working out, avoid motions that flex at the hips or waist as well as overhead lifting, as these can place too much stress on the lower back.
As always, listen to your body and rest when you need to. Consider working with a personal trainer who specializes in pregnancy if you need more guidance.
Incorporating exercise, especially resistance training, into your routine could help prevent or manage your gestational diabetes. To learn more about gestational diabetes and exercise, you can read these articles:
