Structured antenatal exercise protocol versus physical activity counseling—a comparison of two physical activity interventions among women with gestational diabetes mellitus: randomized controlled trial

Objective: To compare the effects of structured antenatal exercise protocol (SAEP) and physical activity counseling (PAC) interventions on glycemic control and perinatal outcome in gestational diabetes mellitus (GDM). Methods: The study utilizes a parallel-design randomized controlled trial in a tertiary care center over a year. Pregnant women with GDM (IADPSG criteria) were recruited between 24 and 28 weeks. SAEP group received an individual face-to-face structured exercise protocol demonstration by physiotherapists followed by home-based exercises. The PAC group received behavioral counseling from obstetricians on strategies to improve physical activity at home and the workplace, along with advice on regular walking schedules. Logbooks were scrutinized, and motivational sessions were reinforced during subsequent visits. All participants received dietary interventions. Anti-hyperglycemic medications were prescribed as necessary by treating obstetricians. Outcome measures were analyzed using Independent t-test, repeated measures ANOVA, Mann–Whitney, Fisher’s exact, and Chi-squared tests. Results: Fifty-one patients (26-SAEP and 25-PAC) were analyzed. Maternal weight gain, glycemic control, glycemic trend at various gestational windows, need for anti-hyperglycemic medications, time from diagnosis to starting medications, dosage of drugs, and weeks in the target glucose range were comparable across the groups. Perinatal outcome parameters, including gestational week of delivery and birthweight, were likewise comparable amongst the groups. No neonatal hypoglycemia. One polyhydraminos and one large for gestational age neonate were found in PAC and SAEP groups respectively. Conclusion: Simple behavioral intervention like PAC by a primary care provider is as efficacious as SAEP in managing GDM. Trial registration: Registered on 08/04/2019, CTRI/2019/04/018448 https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MzIwMjU=&Enc=&userName=