Exercise: The alternative therapeutic intervention for gestational diabetes

As our studies suggest, in the absence of either medical or obstetric contraindications, exercise prescription can be an alternative or adjunct therapy for women who have GDM. With our present knowledge, the exercise regimens and follow-up of these patients must be individualized and medically supervised. The risks of low-intensity exercise during pregnancy in previously sedentary individuals are minimal and predominantly include soft tissue injuries. Non-weight-bearing exercises such as stationary cycling, swimming, and arm exercises, therefore, may be most suitable, but many subjects will tolerate walking programs. Either of the two exercise programs above may prove effective, and the laboratory-based protocol can be adapted for home exercisers who do not need close laboratory monitoring. A standard stationary bike can substitute for a recumbent bike. Along with the exercise program, women with GDM should follow a daily balanced ADA diet of 30 kcal/kg ideal body weight. Physically active patients will need more calories, and all patients must adjust their diet to maintain normoglycemia. Both diet and activities are titrated in relation to glucose control and weight gain. Periodic fetal monitoring is required to ensure fetal well-being. Hypoglycemia is more likely during the first half of pregnancy, when the diabetogenic effect of pregnancy is less pronounced, but hdme glucose monitoring is essential throughout pregnancy.