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首页> 外文期刊>Obesity Science & Practice >Effect of exercise modality on markers of insulin sensitivity and blood glucose control in pregnancies complicated with gestational diabetes mellitus: a systematic review
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Effect of exercise modality on markers of insulin sensitivity and blood glucose control in pregnancies complicated with gestational diabetes mellitus: a systematic review

机译：运动方式对妊娠合并妊娠糖尿病的胰岛素敏感性和血糖控制指标的影响：系统评价

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Summary Background/aim Exercise can be used as a strategy to attenuate hyperglycaemia experienced during gestational diabetes mellitus (GDM). To maximize its use for clinical management, the most effective modality should be identified. The purpose of this review is to elucidate the most effective modality of exercise on insulin sensitivity and blood glucose control in pregnant women with or at risk of GDM. Methods A search was undertaken in MEDLINE, PubMed, Scopus, CINAHL, the Cochrane Library, Embase and the Maternity & Infant Healthcare Database. Studies that met inclusion criteria were randomized controlled trials and case‐controlled studies, which compared exercise interventions with standard care during pregnancy in women with or at risk of GDM. Results Two interventions using resistance training, eight using aerobic exercise and two using a combination of both modalities were included. The interventions showed consistently that requirements of insulin therapy, dosage, and latency to administration were improved in the exercise groups. Less consistent results were observed for capillary blood glucose measurements; however, both modalities and combination of modalities were effective at improving blood glucose control in already diagnosed patients and pregnant women with obesity. Discrepancies in the timing of intervention, GDM diagnostic criteria, and the different measures used to assess glucose metabolism make it difficult to draw clear recommendations. Conclusion Exercising three times per week for 40–60?min at 65–75% age‐predicted heart rate maximum using cycling, walking or circuit training as a modality improved glycaemic control in GDM patients and reduced incidence of GDM in pregnant women with obesity. Further studies looking specifically at the effects of different modalities of exercise on glucose metabolism with combined strategies to enhance insulin sensitivity should be explored to maximize benefits for GDM pregnancies. Consistency in design and delivery of exercise‐only interventions is required to make recommendations on a suitable exercise prescription in this population. In practice, adherence to consensus in diagnostic cut‐offs for GDM diagnosis is fundamental for standardizing future research.
机译：发明内容背景/目的锻炼可以用作减轻妊娠糖尿病（GDM）期间经历的高血糖症的策略。为了最大程度地将其用于临床管理，应确定最有效的方式。这篇综述的目的是阐明在患有或患有GDM的孕妇中，最有效的运动方式对胰岛素敏感性和血糖控制具有重要意义。方法在MEDLINE，PubMed，Scopus，CINAHL，Cochrane图书馆，Embase和母婴保健数据库中进行搜索。符合入选标准的研究是随机对照试验和病例对照研究，它们将妊娠干预措施与患有GDM或有GDM风险的妇女的标准护理进行了比较。结果包括两种采用阻力训练的干预措施，八种使用有氧运动的干预措施，两种采用两种方式的组合。干预措施一致表明，运动组对胰岛素治疗的要求，剂量和给药潜伏期得到改善。毛细血管血糖测量结果不一致。然而，两种方式和多种方式的组合均能有效改善已确诊的肥胖患者和孕妇的血糖控制。干预时间，GDM诊断标准以及用于评估葡萄糖代谢的不同措施之间的差异使得很难提出明确的建议。结论每周三次以65-75％年龄预测的最大心率进行40-60分钟的锻炼，使用自行车，步行或巡回训练作为一种方式可以改善GDM患者的血糖控制，并降低肥胖孕妇的GDM发生率。应该进行进一步研究，专门研究不同运动方式对葡萄糖代谢的影响，并结合增强胰岛素敏感性的策略，以最大程度地增加妊娠糖尿病的收益。需要在仅运动干预措施的设计和实施上保持一致，以针对该人群的合适运动处方提出建议。实际上，在GDM诊断的诊断临界值中遵守共识是标准化未来研究的基础。

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