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Gestational‌ ‌Diabetes‌ ‌Mellitus‌ ‌(GDM)‌ ‌and‌ ‌Exercise‌

January 11, 2021
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GDM is defined as 'Carbohydrate intolerance with first recognition or onset during  pregnancy'. GDM is a primary concern in India affecting  millions of pregnant women each year.

Women with gestational diabetes are at subsequent high risk of type 2 diabetes, Also Exposure to hyperglycemia in the womb predisposes baby to a high risk of becoming overweight or obese, associated with the development of type 2 diabetes.

Book an online appointment with Hemavathi Jagadesh physiotherapy related issues.

A good news is expectant mothers can control gestational diabetes by Eating healthy foods, a planned  Exercise program and if necessary taking Medication as per your doctor advise. Controlling blood sugar can keep you and your baby healthy and prevent a difficult delivery.

CAUSES OF GDM AND RISK FACTORS

GDM is caused by altered insulin sensitivity or resistance due to hormonal secretions  like lactogen, leptin, cortisol, prolactin, estrogen during pregnancy.

Some women have a greater risk of gestational diabetes. Risk factors includes:

  • Overweight and obesity.
  • Lack of physical activity/Sedentary lifestyle
  • Age > 30
  • Previous gestational diabetes or prediabetes
  • Polycystic ovary syndrome
  • Family history of diabetes
  • Previously delivering a baby with more weight


SYMPTOMS

GDM doesn't cause noticeable signs or symptoms in a few people.

Increased or unusual  thirst, more-frequent urination ,fatigue, increased appetite, blurred vision  are possible symptoms.

Complications that may affect baby

  • Excessive birth weight. 
  • Early (preterm) birth. 
  • Low blood sugar (hypoglycemia). 
  • Obesity and type 2 diabetes later in life.
  • Stillbirth

Complications that may affect Pregnant women

  • High blood pressure and preeclampsia. 
  • Surgical delivery (C-section). 
  • Risk of developing  diabetes.

Prevention of GDM

  • Eat healthy foods-Choose foods high in fiber, low in fat and calories. Focus on selected fruits, vegetables and whole grains. 
  • Keep active -Exercising before and during pregnancy can help protect you from developing gestational diabetes. 
  • Start pregnancy at a healthy weight.
  • Don't gain more weight than recommended during pregnancy.


Exercises for GDM

Safe and Effective Exercise has a powerful potential to assist with blood glucose control.

Effective support program for

  • Weight management and
  •  Increasing physical activity to at least 150 min per week of moderate activity helps in control of GDM.


BENEFITS OF EXERCISE DURING PREGNANCY

  • Improve cardiovascular functions such as fitness, blood pressure, and peripheral oedema.
  • Preeclampsia has  decreased with an increase in physical activity
  •  Decrease the risk of developing GDM and type 2 diabetes
  •  Reduces the vast effects of hyperglycemia on the women, fetus and child 
  •  As pregnancy is a period associated with physiological and psychological changes, exercise  benefits on hormonal balance ,mood swings  and psychological well being.
  •  Due to  limitation in weight gain and fat retention, exercise  improve self confidence of individual, reduce insomnia and fatigue


Other benefits for Labor and Fetus


  • Lower heart rate response to acute maternal exercise
  • Higher tolerance to labour
  • Lower birth weights
  • Increased gestational ages (lower risk of preterm birth)
  • Increased in placenta viability and volume
  • Improved neurodevelopment and lower body fat percentage
  • Increase in vascular function and placental growth 
  • Infants have higher behaviour regulatory ability and orientation


Exercise prescription  for GDM

Exercises are prescribed by physiotherapists depending on the individual patient's history, medical conditions, fitness and FITT (frequency, intensity, time/duration and type) principles.

  • Low impact aerobics (large muscle activities in a rhythmic manner) e.g., walking, swimming ,dancing
  • 4-5 Days per week ,30 -40 minutes
  • Resistance (multi joint exercises, large muscle groups) e.g., light weight dumbbells, resistance band ,pregnancy Pilates,body weight exercises.
  • 2-3 Days per week 20 -30 minutes
  • Stretching exercises for Flexibility and Relaxation.
  • 5 Days per week 15 to 30 minutes or added during static postures at workplace or home 

  • Things to remember while exercising

    • Discuss with your obstetrician and physiotherapist  to begin any  exercise program
    • Don't hold breaths during exercises ,Breathe evenly throughout the exercises
    • Maintain  good posture
    • Use light weights and keep the number of repetition 8 -15 counts, progress from less counts to achieve higher counts
    • Watch your blood sugar level. If you exercise after a meal, wait to eat your snack until after your workout, If it's been 2 hours or more since a meal, eat your snack first, then exercise
    • Avoid Jumping, bouncing ,end range stretches ,lifting heavy weights and  jerky motions
    • Rehydrate frequently
    • Take Rest breaks, when required

    Missing a workout is normal to any person, get back to track  in one or two days. Follow your exercise program regularly till your due date , talk to your physiotherapist if any difficulty.


    TODAYS ACTIONS ARE TOMORROW'S RESULT.

    BE ACTIVE, STAY HEALTHY AND HAPPY. 

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