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Women with gestational diabetes unlikely to receive counseling on physical activity

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December 27, 2018

Physical activity is low among women with gestational diabetes, and common deterrents to regular exercise include living with a partner, lower income and having multiple children, according to findings published in the Journal of Diabetes.

“Physical activity improves glycemic control, insulin resistance and weight gain, important elements for the management of [gestational diabetes] and prevention of [type 2 diabetes],” Fabrício B. Del Vecchio, PhD, a professor in the Laboratory of Biochemistry and Physiology of Exercise (LABFEX) at Federal University of Pelotas in Brazil, and colleagues wrote. “Greater knowledge regarding physical activity and its determinants during pregnancy may contribute to the development of actions to promote a more active behavior in this important population at risk.”

Del Vecchio and colleagues performed a cross-sectional study of a multicenter, randomized clinical trial in Brazil. A total of 2,706 women with recent gestational diabetes (mean age, 31.3 years) were included. Physical activity was self-reported using the International Physical Activity Questionnaire; medical records indicated weight before and during pregnancy, plasma glucose levels, treatment for gestational diabetes and reproductive history.

The researchers interviewed participants to determine income level, whether they lived with a partner, worked, smoked before pregnancy, had hypertension and took medication for gestational diabetes. Activity level status for all participants was categorized as either inactive (0 to 10 minutes of activity per week), insufficiently active (11 to 149 minutes of activity per week) or active (150 or more minutes of activity per week).

Most participants (63.1%) reported decreasing physical activity during pregnancy with 39.7% categorized as insufficiently active and 26% as inactive. Women who were inactive or insufficiently active had higher levels of fasting plasma glucose than those in the active group (P < .001), but the researchers observed no significant differences in glucose concentrations at 1 hour or 2 hours after a glucose load between the three groups.

Fewer than half of the participants received counseling about physical activity either before (47.4%) or after (34.3%) a diagnosis of gestational diabetes. The researchers found that women who were inactive were more likely to receive advice discouraging physical activity (19.7%) than those who were insufficiently active (10.4%) or active (8%; P < .001).

“Counseling for [gestational diabetes] women is an important intervention for management of the condition,” the researchers wrote. “For this reason, [it] is necessary that professionals involved in treating [gestational diabetes] offer adequate service to improve the quality of information and provide proper advice about the necessity of health care.”

The researchers also found that activity levels were negatively affected by living with a partner (P < .001), having a lower income (P < .041), being employed (P < .001) and having more than one child (P < .001).

“It should be noted that the women recruited to this study were using the public health care system, and this sample is generally poorer compared with private system [users],” the researchers wrote. “This highlights that the aspects negatively affecting physical activity in the present study could be minimized by public policies that consider the life condition and provide greater social support to pregnant women and mothers.” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures. 

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