Effect of physical activity promotion program on insulin resistance and glycemic control in gestational diabetes mellitus: a randomized controlled trial

Background: A combined effect of increased insulin resistance (IR) due to placental hormones and insufficient insulin production due to pancreatic β-cell dysfunction leads to gestational diabetes mellitus (GDM). As gestational age progresses, pregnancy-related discomfort and concerns related to the safety of performing activities lead to reduced physical activity (PA) levels. This reduction further increases IR and impairs glycemic control. Thus, the objective of this study was to determine the effects of the Physical Activity Promotion (PAP) program on IR and glycemic control in GDM. Methods: In this randomized controlled trial, 120 participants with GDM were randomly assigned to either an intervention group or a control group. The participants in both groups received regular prenatal care provided at the hospital. The participants in the intervention group received a physical activity promotion (PAP) program for eight weeks. IR, fasting blood glucose (FBG), postprandial blood glucose (PPBG), and PA levels were assessed at baseline and the end of eight weeks. A mixed model with random effects as participants was used for the analysis of outcomes. Results: The mean age of all the included participants in the study was 29.8 ± 3.66 years, and the gestational age was 26.4 ± 1.38 weeks. Significant differences in IR (F = 44.62, p < 0.001), FGB (F = 25.2, p < 0.001), and PPBG (F = 6.98, p = 0.009) were detected between the groups over time. Conclusion: The PAP program effectively reduced IR and improved glycemic control in GDM.