Effects Of Resistance Training On Blood Sugar And Pregnancy Outcomes In Patients With Gestational Diabetes Mellitus

Objectivs1.To explore whether resistance training has an effect on blood sugar levels and pregnancy outcomes in patients with GDM in randomized controlled trials,a meta-analysis was conducted.2.Randomized controlled trials were conducted to investigate the effect of resistance training on blood glucose,insulin and pregnancy outcome in patients with gestational diabetes mellitus compared with aerobic exercise,so as to provide guidance and basis for lifestyle intervention in patients with GDM.Methods1.Pubmed,Cochrane Library,CINAHL,Embase,Scopus,Web of Science,Clinical Trials,CKNI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database were systematically searched since their establishment to April 2019.Relevant meta-analyses,reviews,and eligible literature were also searched.The quality of the included literature was evaluated according to the Cochrane Assessment Manual 5.1.0.Meta-analysis was performed using Revman 5.3 software.2.Randomized controlled trial: A total of 100 patients with gestational diabetes mellitus were selected from class 3 first level general hospital in Fujian province from December 2019 to December 2020,and randomly divided into resistance training group(49 cases)and aerobic exercise group(51 cases).The aerobic exercise group received aerobic exercise and routine nursing(personalized diet intervention,online education,school for pregnant women).The resistance training group received resistance training and routine nursing(personalized diet intervention,online education,school for pregnant women).The differences of fasting and 2h postprandial blood glucose,insulin use,positive rate of urinary ketone body,adverse pregnancy outcome and compliance of exercise were compared between the resistance training group and the aerobic exercise group after intervention.Results1.A total of four studies(n = 250 patients)were included.Compared to the control group,there were statistical differences in fasting blood glucose level[MD=-0.37,95%CI=(-0.65,-0.09),Z = 2.62,P = 0.009],average 2h postprandial blood glucose level [MD=-0.96,95%CI=(-1.80,-0.12),Z = 2.25,P = 0.02],insulin dosage [MD=-0.58,95%CI=(-0.99,-0.17),Z = 2.75,P = 0.006],rate of insulin injection [RR=0.52,95%CI=(0.31,0.86),Z = 2.54,P = 0.01],and incidence of macrosomia [RR=0.15,95%CI=(0.04,0.66),Z = 2.53,P = 0.01]in the intervention group consisting of GDM patients.There were no statistical differences in preterm delivery outcomes [RR=0.44,95%CI=(0.09,2.16),Z = 1.01,P = 0.31].2.There were statistically significant differences in fasting blood glucose(P=0.043)and2h postprandial blood glucose(P<0.0001)in the resistance training group after intervention compared with before intervention.There were statistically significant differences in fasting blood glucose(P=0.031)and 2h postprandial blood glucose(P<0.0001)in the aerobic exercise group after intervention compared with before intervention.There were no significant differences in fasting blood glucose(P=0.614),use rate of insulin(P =1.000),positive rate of urinary ketone body(P=1.000)and incidence of adverse pregnancy outcome(P > 0.05)between the resistance training group and the aerobic exercise group after intervention.There were statistically significant differences in 2h postprandial blood glucose(P =0.019)and compliance of exercise(P =0.031)between the resistance training group and the aerobic exercise group after intervention,and the resistance training group was better than the aerobic exercise group.Conclusion1.Resistance training can improve blood sugar levels,insulin usage,and some adverse pregnancy outcomes in patients with GDM.2.Both the resistance training group and the aerobic exercise group can improve the fasting blood glucose and 2h postprandial blood glucose in patients with GDM.Although the effects of resistance exercise and aerobic exercise on blood glucose,insulin,pregnancy outcome and other aspects of GDM patients are only statistically different in 2h postprandial blood glucose,resistance exercise is worth popularizing because the compliance of resistance exercise is higher than aerobic exercise,but its long-term effects need to be further defined in the future.