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Semin Reprod Med 2020; 38(06): 398-406
DOI: 10.1055/s-0040-1722208
Review Article

The Role of Lifestyle Intervention in the Prevention and Treatment of Gestational Diabetes

Trine Moholdt
1   Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
2   Women's Clinic, St. Olav's Hospital, Trondheim, Norway
,
Melanie Hayman
3   School of Health, Medical and Applied Sciences, Physical Activity Research Group, Appleton Institute, CQ University, Rockhampton, Australia
,
Soulmaz Shorakae
4   Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
5   Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Australia
,
Wendy J. Brown
6   School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
,
Cheryce L. Harrison 
4   Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
5   Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, Australia
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Abstract

Obesity during pregnancy is associated with the development of adverse outcomes, including gestational diabetes mellitus (GDM). GDM is highly associated with obesity and independently increases the risk of both complications during pregnancy and future impaired glycemic control and risk factors for cardiovascular disease for both the mother and child. Despite extensive research evaluating the effectiveness of lifestyle interventions incorporating diet and/or exercise, there remains a lack of definitive consensus on their overall efficacy alone or in combination for both the prevention and treatment of GDM. Combination of diet and physical activity/exercise interventions for GDM prevention demonstrates limited success, whereas exercise-only interventions report of risk reductions ranging from 3 to 49%. Similarly, combination therapy of diet and exercise is the first-line treatment of GDM, with positive effects on maternal weight gain and the prevalence of infants born large-for-gestational age. Yet, there is inconclusive evidence on the effects of diet or exercise as standalone therapies for GDM treatment. In clinical care, women with GDM should be treated with a multidisciplinary approach, starting with lifestyle modification and escalating to pharmacotherapy if needed. Several key knowledge gaps remain, including how lifestyle interventions can be optimized during pregnancy, and whether intervention during preconception is effective for preventing the rising prevalence of GDM.

Keywords

pregnancy - gestational diabetes mellitus - exercise - diet - lifestyle therapy - prevention - treatment


Publication History

Article published online:
20 January 2021

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