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Gestational Diabetes Mellitus (GDM) And Importance of Physiotherapy in GDM

November 23, 2021
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Increased sugar levels in pregnancy? Do not panic .Let’s have a look at what exactly happens during pregnancy for the sugar levels to rise.

Gestational diabetes mellitus (GDM) is any degree of glucose intolerance with the onset or first recognition during pregnancy. This is irrespective of the form of treatment or whether it continues after pregnancy.

Prevalence of GDM may range from 1-14% depending on the population, age, co morbid factors, weight, BMI. Almost 4% of all pregnancies have complications due to GDM.

A lot of changes happen during pregnancy, major ones being hormonal changes. The hormones cortisol and estrogen increases as the pregnancy progresses leading to insulin resistance and increase in sugar levels. The maximum effect of these hormones is seen from 26th week to 33rd week. Thus the screening of GDM happens between 24th and 28th week of gestation.

Regular monitoring of sugar levels can keep the baby and the mother away from its complications.

Book an Appointment with Ms. Mithila Pawar for all Physiotherapy related concerns and sessions.

The risk categories for GDM are –

High risk – marked obesity, glycosuria (presence of sugar in urine), diabetes in 1st relative 

Low risk- age below 25, normal weight gain 

Average risk – do not fit in any of the above categories should undergo screening test between 24-28th week of gestation.

Diagnosis of GDM is done by doing a glucose tolerance test. In this test oral 75gms of glucose is given to the patient and the sugar levels are monitored after 2 hours. The cut off value is >140 mg/dl .Anything above 120mg/dl regular monitoring is required. 

Must Read - Learn more about Gestational Diabetes!

Maternal and fetal complications:

  • Maternal
  • Polyhydramnios (increased amniotic fluid)
    Birth injuries
  • Pre-eclampsia (increased blood pressure)
    Congenital malformations
  • Prolonged labor
    Still birth
  • Obstructed labor
    Spontaneous abortion
  • Postpartum hemorrhage
    Intrauterine death
  • Infection
    Infant respiratory distress syndrome (difficulty in breathing)
  • Caesarean
    Shoulder dystocia

Physiotherapy Management:

Physiotherapy plays a vital role in GDM. Sedentary women are more prone for GDM as compared to women who are having an active lifestyle.

Resistance exercises  

Aerobic exercises

According to the ACSM guidelines min 3 days a week exercises are recommended. 

A combination of aerobic and resistance exercises is recommended. 

It is recommended to walk 30-40 min at least thrice a week and resistance exercises twice a week under supervision. A combination of both these exercises will gradually maintain/ reduce the sugar levels.

According to ACSM guidelines FIIT principle is used for exercise

Frequency: 3-5 times a week 

Intensity: Moderate to somewhat severe intensity according to modified borg’s scale or 60-90% of HR max. These things are evaluated by your physiotherapist and then the exercise plan is made for you.

Time: 30-40 min/day

Type: combination of aerobic exercises and resistance exercises of upper and lower limbs.

These exercises are to be started only under the supervision of physiotherapists after detailed evaluation of your reports and pregnancy scans, weight gain, sugar levels etc.

It is also been observed that Gestational Diabetes Mellitus mothers are more prone for diabetes mellitus post-delivery along with increased risk for the infants to develop glucose intolerance .

Physiotherapy not only does play a role during pregnancy for maintaining sugar levels but also important in the post delivery period in reducing weight and maintaining sugar levels as a part of rehab. 

Must Read - The Truth About Gestational Diabetes - Sugar Ain’t Always Sweet, Darlin.

Early diagnosis can always lead to less complications and a smoother pregnancy and delivery process. So now that we all are aware of GDM and physiotherapy, let’s spread the word!

Want to consult the Best Pediatricians in India? Please find the links below.

  1. Best Physiotherapists in Bangalore
  2. Top Physiotherapists in Chennai
  3. Best Physiotherapists in Mumbai
  4. Top Physiotherapists near me in Pune
  5. Best Physiotherapists in Chandigarh
  6. Top Physiotherapists near me in Gurgaon
  7. Best Physiotherapists in Noida
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