Exercise: The Overlooked Ally in Gestational Diabetes

One of the most prevalent pregnancy-associated health conditions is Gestational Diabetes Mellitus (GDM), which occurs among 10-14% of pregnancies in India, and it is also alarmingly escalating in urban settings.

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In pregnancy,?women with GDM are at risk for adverse pregnancy outcomes, such as preterm delivery, macrosomia, and cesarean section. In addition, women with a history of GDM continue to have an increased risk of developing type 2 diabetes in the future. Studies have shown that postpartum physiotherapy programs involving both aerobics and resistance exercise can help reset glucose metabolism and reduce the risk of developing diabetes by as much.

The Standard Care-and What's Missing

Gestational diabetes is typically managed throughMedical nutrition therapy (customized diets to control blood sugar), Pharmacological interventions,&Glucose monitoring via regular blood tests.However, physiotherapy& exercise are rarely integrated into care plans, despite global guidelines from the World Health Organization (WHO) and American College of Obstetricians and Gynecologists (ACOG) endorsing structured exercise as a cornerstone of GDM management. International recommendations advocate the use of structured exercise as a cornerstone in the management of GDM. The ACOG recommends 150 minutes/week of moderate aerobic activity, as well as resistance training, while the International Federation of Gynecology and Obstetrics (FIGO) highlights lifestyle modification as an integral element of GDM management.

Physiotherapy Role in GDM Management

Pregnancy encompasses many physiological changes such as weight gain, hormonal changes, and changes in insulin sensitivity. These changes are amplified in women with GDM, in whom increased insulin resistance contributes to elevated blood glucose. Physiotherapeutic exercises, when prescribed using the FITT principle (Frequency, Intensity, Time/Duration, and Type), play a vital role in managing gestational diabetes by offering a targeted and multidimensional approach tailored to the unique needs of pregnant women. Exercise helps in GDM regulation inthe following ways: