Physical exercise is associated with glycemic control among women with gestational diabetes mellitus: Findings from a prospective cohort in shanghai, china

Abstract

Objective: Physical exercise during pregnancy is beneficial to women with gestational diabetes mellitus (GDM), but evidence on the association between physical exercise and glycemic control among women with GDM is limited in China. We conducted this study to understand the total exercise times, the percentage of abnormal plasma glucose (PG), and to explore if longer physical exercise is positively associated with a lower percentage of abnormal PG among GDM women. Methods: During 2019 and 2020, we established a prospective cohort with 1,050 GDM women recruited. GDM was confirmed by a diagnostic 75g OGTT, and plasma glucose in over 10 hours overnight fasting and 2-hour after breakfast was implemented during a routine antenatal checkup. Information for demographic features and physical exercises among GDM women were collected by questionnaire interviews, and abnormal PG percentage was calculated as abnormal PG times divided by total PG test times. Results: Among 1,050 GDM women, the percentage of exercise times <150 minutes/week, <30 minutes/day and <60 minutes/day was 17.33%, 26.57%, and 54.10%, respectively. The median percentage of abnormal PG was 40% (IQR=20–70%). GDM women with less exercise had a higher abnormal PG percentage (y=0.0049x2-1.20x+88.96), ORs for women with exercise <150 minutes/week were 3.78 (95% CI=1.33–8.25), 6.97 (3.45–14.07), and 6.39 (3.61–11.33) compared with ≥ 150 minutes/week, and ORs for women with exercise <60 minutes/day were 4.62 (2.71–8.14), 3.58 (2.60–4.93), and 7.28 (4.31–12.30) compared with ≥60 minutes/day in groups divided by quartiles of P25, P50 and P75, respectively. Conclusion: This study indicated high physical exercise times and abnormal PG percentage among women with GDM in Shanghai, China. GDM women with more exercise times had a lower percentage of abnormal PG, especially when exercise times were ≥60 minutes/day, and supplementary treatments should be provided for women with over 70% abnormal plasma glucose.