# Effect of exercise interventions on glycemic control in women with gestational diabetes mellitus: a systematic review and meta-analysis

## TL;DR

Exercise helps control blood sugar in pregnant women with gestational diabetes, with specific timing and frequency being more effective than standard guidelines.

## Contribution

This study provides updated evidence on optimal exercise protocols for managing blood glucose in gestational diabetes.

## Key findings

- Exercise significantly reduced fasting blood sugar, postprandial glucose, and HbA1c in women with gestational diabetes.
- Exercising 15 minutes after meals and 7-10 times per week was more effective than current recommendations.
- The study analyzed 15 RCTs using a random-effects model to assess exercise's impact on glycemic control.

## Abstract

This study aimed to examine the overall impact of randomized controlled trials (RCTs) assessing the effects of exercise interventions—considering program duration, timing, and type—on blood glucose control in women with gestational diabetes mellitus (GDM), thereby improving the reliability of evidence in this field.

For this systematic review and meta-analysis, we searched major international and domestic databases (PubMed, Embase, Cochrane, CINAHL, RISS, DBpia, NSDL, and KISS) for RCTs published up to December 2024 in English or Korean. Participants were pregnant women diagnosed with GDM. Interventions involved exercise for blood glucose management, while the control group received routine care. The outcome variables were blood glucose levels, including fasting blood sugar (FBS), 2-hour postprandial glucose (PPG2hr), and glycated hemoglobin (HbA1c). Fifteen studies were selected and analyzed using a random-effects model, with mean difference (MD) and 95% confidence interval (CI).

Glycemic parameters in the exercise group improved significantly compared with those in the routine care group: FBS, –0.47 mmol/L (n=963; MD=–0.47; 95% CI, –0.69 to –0.24; p<.001), PPG2hr, –0.62 mmol/L (n=944; MD=–0.62; 95% CI, –0.84 to –0.40; p<.001), and HbA1c, –0.39% (n=259; MD=–0.39; 95% CI, –0.53 to –0.25; p<.001).

Exercise intervention is an effective strategy for regulating blood glucose levels in women with GDM. Moreover, engaging in exercise approximately 15 minutes after meals and scheduling sessions 7 to 10 times per week may be more effective than current recommendations of at least 30 minutes of exercise three times weekly.