Exercise and gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is defined as carbohydrate intolerance of any degree first manifested during pregnancy. It is related to a numerous complications and adverse outcomes during pregnancy. The primary goals of treatment are to achieve acceptable glycemic control and improve pregnancy outcomes, with changes in diet and lifestyle as primary therapeutic strategies. Exercise of moderate intensity is recommended for all pregnant women without contraindications, including those with GDM. The purpose of this article is to provide an overview of preventive and therapeutic effects of exercise before and during pregnancy on the incidence, course and outcomes of GDM. Data on preventive and therapeutic effects of exercise before and during pregnancy are mainly based on cohort studies and a small number of randomized controlled trials. Cohort studies relate higher levels of physical activity before and during early stages of pregnancy with lower incidence of GDM. Aerobic exercise and resistance training after the diagnosis of GDM have some beneficial effects on glycemic control parameters and the need to apply insulin therapy. Definitive effects of exercise for GDM prevention and management are still uncertain and the optimal exercise parameters need to be determined. Exercise before and during pregnancy might reduce GDM incidence and improve the course and the outcomes of GDM, but more randomized clinical trials are needed in this area.