ABSTRACT
Objective: To evaluate the efficacy of an exercise intervention,
in addition to usual care, to prevent or delay insulin prescription in
women with gestational diabetes mellitus (GDM).
Design: Randomised controlled trial
Setting : University hospital
Population : Women at 25-35 weeks pregnancy upon diagnosis of GDM.
Methods : In the intervention arm, women had weekly, supervised,
30-45 min long exercise sessions and were encouraged to accumulate more
than 5000 steps per day, monitored by a pedometer, in addition to usual
care. Women in the control group had usual care only.
Main outcome measure : Insulin prescription.
Results: From February 2008 through April 2013, 109 women were
randomized into intervention (n=57) or usual care (n=52). Two women,
both in the intervention group, were excluded from the analysis (one
randomised in error and one lost to follow-up). Six women never attended
the exercise sessions and two women participated to less than two
sessions, while two-third of women were considered as compliant to the
intervention. Incidence of insulin prescription was not significantly
different between groups: 31 (56%) in the intervention and 24 (46%) in
the control group (RR 1.22, 95% CI 0.84 to 1.78); the median time
between randomization and insulin prescription was not different between
groups (14 and 13 days, respectively).
Conclusion: We were unable to show that an exercise program
reduces or delays insulin prescription. Low compliance with the
intervention, small sample size and the short duration of the program
may explain the apparent lack of benefit. (registered at
clinicaltrials.gov, NCT03174340)
Funding : Clinical Research Centre of the Faculty of Medicine,
University of Geneva, and the University Hospitals of Geneva,
Switzerland.
Keywords : exercise, gestational diabetes, randomised trial,
insulin
Tweetable abstract: A small RCT failed to show a benefit from
exercise sessions in women with gestational diabetes