The effects of an exercise program on insulin sensitivity and plasma glucose levels in women at high risk for gestational diabetes.

Pregnancy is a period in the live of women that may result in decreased daily physical activity and/or exercise. This change often occurs despite the fact that there is no medical reason for women to reduce their daily physical activity levels and/or exercise. However, maintaining adequate levels of daily physical activity during pregnancy may be important for mother and child. Studies of daily physical activity or exercise and the occurrence of maternal pregnancy related disorders suggest that moderate daily physical activity and exercise during pregnancy may be associated with reductions in the risk of gestational diabetes mellitus (GDM). However, at the moment, physical activity is not routinely advised or prescribed for women at risk for gestational diabetes in the Netherlands.

In this study we aim to assess whether an exercise program can improve insulin sensitivity and fasting plasma glucose levels of women at high risk for gestational diabetes, assuming that this will normalise their risk of gestational diabetes.

This study is a randomised controlled trial. 160 women at risk for gestational diabetes will be randomly allocated to two groups; an intervention (n = 80) and a control group (n = 80). The intervention group will receive an exercise program twice a week in addition to usual care, and the control group will receive usual care only.

Primary maternal outcome measures are fasting plasma glucose and relative increase in insulin resistance. Primary neonatal outcome is birth weight.
Secondary outcome measures are: maternal serum triglycerides, maternal weight gain during pregnancy, maternal physical activity level, fetal growth.
The intervention will be an exercise program twice a week during the remaining duration of the pregnancy. Trainers have expertise with providing exercise training for pregnant women. Exercises will be adjusted to the fitness and endurance level of the women at the start of the intervention and later on to their stage of pregnancy.

Increasing levels of physical activity during pregnancy may be an effective
strategy for the prevention of GDM.

N/A

An exercise program consisting of aerobic and strength exercises will be provided twice a week during the remaining duration of the pregnancy after randomisation.