Exercise Guidelines for Gestational Diabetes

Let's chat about the exercise guidelines for gestational diabetes. Yes, you can exercise when you have gestational diabetes in pregnancy as long as your doctor says it's OK. By staying fit and active you will be able to better manage your blood sugar.

It's important you understand the exercise guidelines for gestational diabetes during pregnancy as it will help to ensure you enjoy a healthier pregnancy.

Let's begin by talking about what the research says so you can better understand what you can do to reduce your chances of getting gestational diabetes.

Introduction

Did you know that obesity and type 2 diabetes prevalence are increasing among women of child-bearing age?

Women of childbearing age are at an increased risk for obesity (Villamor & Cnattingius, 2006) and type 2 diabetes (Lipscombe & Hux, 2007) because of excessive weight gain during pregnancy and weight retention after delivery.

Maternal Obesity

Maternal obesity is associated with impaired glucose metabolism. Did you know that if you start your pregnancy overweight or obese that there is increased chance of  numerous unfavourable pregnancy outcomes? Such as the development of impaired glucose tolerance (IGT) or GDM (Catalano and Ehrenberg, 2006; Chu et al., 2007; Davies et al., 2010; Nelson et al., 2009).

Exercising when Pregnant is a Part of a Healthy Pregnancy

It is highly recommended that you exercise throughout your pregnancy in order to achieve the health benefits during pregnancy. Being inactive may put you and your growing baby at risk for disease through altered maternal pregnancy adaptations (Mottola 2008).

Studies have shown that women who were the most active before pregnancy (Chu et al. 2007) and throughout pregnancy had the lowest prevalence of GDM.

Working Out When Pregnant is Associated With Preventing Excessive Gestational Weight Gain.

A study found that decreased physical activity was associated with excessive gestational weight gain (GWG) (Olson & Strawderman, 2003). Lifestyle intervention studies delivered evidence to show that exercising during pregnancy had successful results with respect to the prevention of excessive weight gain.

Summary and Recommendations

If modifiable risk factors for developing diabetes when pregnant, such as preventing excessive weight gain, can be reduced by exercising, then exercise can be used as a powerful tool to reduce the diabetes and obesity epidemics in successive generations.

In other words, not only does staying fit and healthy during pregnancy impact on your health, but it also plays a role in your child's future health.

So What Exactly is Gestational Diabetes?

Gestational diabetes is a form of diabetes that occurs during pregnancy and usually goes away after the baby is born. It is diagnosed when higher than normal blood glucose levels first appear during pregnancy.

Between 5% - 10% of pregnant women will develop gestational diabetes and this usually occurs around the 24th to 28th week of pregnancy.

How Will I Know if I have Gestational Diabetes?

All women are tested for gestational diabetes as part of the 24-28 week routine examination with their GP.

If you live in a country where you do not receive such regular check-ups then it would be advised to speak directly to your doctor about being tested for gestational Diabetes.

Women who have one or more of the risk factors are advised to have a diabetes test when pregnancy is confirmed then again at 24 weeks if diabetes was not detected in early pregnancy.

Most women are diagnosed after special blood tests. A Glucose Challenge Test (GCT) is a screening test where blood is taken for a glucose measurement one hour after a glucose drink.

If this test is abnormal then an Oral Glucose Tolerance Test (OGTT) is done. For an OGTT a blood sample is taken before and two hours after the drink.

What You Eat is Very Important

If you have gestational diabetes during pregnancy it is advised that you consult a nutritionist that specializes in gestational diabetes. Your Doctor will be able to refer you to a nutritionist in your local area.

To effectively manage gestational diabetes, it is important that you control your blood glucose levels. You can do this by maintaining a healthy diet as well as participating in a regular moderate intensity exercise program in consultation with your doctor.

Know What to Eat

When you are diagnosed with gestational diabetes you will work closely with a Dietitian who specializes in this area. They will be able to advise you on what to eat throughout the day as well as give you some suggestions for a good pre-workout meal. This could be a serving of fruit.

If you are at risk of getting GDM, then one way to help prevent it is to eat a healthy diet. What you eat plays the leading role in blood sugar control.

By eating a nutrient-rich diet combined with regular exercise can help reduce or eliminate your risk of developing this condition.

When to Eat

If you choose to do your prenatal workout right after a meal, then wait to eat your snack until after your workout. But if it's been two hours or more since you ate your last meal meal, then eat your snack first before you start exercising.

How Prenatal Exercise Affects Gestational Diabetes

Participating in a

pproved prenatal exercise plan can help in preventing and treating gestational diabetes. Doing your prenatal workouts on a regular basis throughout the week may help regulate your blood sugar levels and even reduce the risk of gestational diabetes factors and complications.

How Can I Lower My Risk with Exercise?

Recent studies on gestational diabetes and exercise support the role of prenatal exercise in preventing and managing the disease. Maintaining a consistent prenatal fitness program may assist in managing daily blood sugar levels.

If you are at risk of gestational diabetes (or already have GDM) then your workouts should consist of moderate exercise for at least 30 minutes. Try to workout at least five days per week to accumulate the recommended 150 minutes per week of exercise for a pregnant woman.

All with all pregnant mamas, you need to modify any exercise as necessary.

At PregActive, we make starting a prenatal fitness routine as easy and affordable as possible. Take the guess work out of which exercises are safe and which ones are not.

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Your Prenatal Workouts Must be Safe for You and Baby

Research has shown that exercise is not dangerous for your baby as long as you know which exercises are safe and which exercises you must avoid. That is now well accepted by all health professionals which is why they will recommend exercise for pregnant women. In saying, that there are some conditions that may prevent you from exercising so please be sure to follow your doctor's advice.

Once your doctor has given you the all clear then you need to do your due diligence in finding a qualified prenatal exercise instructor. Whether you choose to participate in online workouts or in-studio classes; you need to have trust in your instructor that they are qualified and experienced to be prescribing exercise to pregnant women.

What if I Didn't Exercise Before Pregnancy?

If you did not exercise on a regular basis before getting pregnant then, with your doctor's approval, you can start now you are pregnant. Make sure you start with a beginner class that is non-impact and that is shorter in duration. My Prenatal Mobility classes are ideal for beginners.

As you progress deep into your third trimester you may find you slow down naturally as your bump grows.;

Exercise Guidelines for Gestational Diabetes Mellitus

1. Mode of Exercise

When pregnant you need to modify your workouts. Walking, swimming, stationary cycle, prenatal exercise classes, and prenatal yoga are recommended.

2. Frequency

Aim to workout 5 days a week. If you can only do 3 days then that is just fine. Try increase these days as you improve your fitness. Remember to do your pelvic floor exercises.

3. Duration

The ideal workout range is 30 min/session. But anywhere between 20 - 40 minutes is good depending on your personal fitness level.

4. Strength Training

Include light or moderate strength training exercises and avoid heavy lifting that cause over-straining. Make sure you avoid activities that involve lying flat on the back after 16 weeks.

5. Exercise Intensity Level when Pregnant

What about exercise intensity when pregnant? In years past they used a target heart rate as a guide but that has now been replaced by ACOG who recommend that you use the Talk Test or Rate of Perceived Exertion guide. Basically, if you become breathless, you're probably pushing yourself too hard.

Related: Exercise Target Heart Rate when Pregnant

6. Progression

When starting out I want you to only increase duration of moderate exercise slowly. Begin with a prenatal mobility class and from there you can progress to a yoga, Pilates of PregActive FIT class.

Common Questions

How much should you exercise with gestational diabetes?

It is recommended that women with GDM should do both cardio and strength training at a moderate intensity, a minimum of three times a week for 30-60 min each time.

Does exercise reduce gestational diabetes?

Yes, Exercise has been proven to be beneficial in improving pregnancy outcomes in women with gestational diabetes. When you exercise that makes your heart beat a little faster and breathe a little harder. Your muscles use more glucose, the sugar in your blood stream. Over time, this can lower your blood sugar levels. It also makes the insulin in your body work better.

Is walking good for gestational diabetes?

Yes, walking is a great form of exercise you can do when pregnant. As already mentioned, exercise will improve your health.

What is the best exercise for gestational diabetes?

You still need to know which exercises you can and cannot do. So stick to the best prenatal workouts that include, walking, prenatal yoga, Pilates, and swimming.

What Causes Gestational Diabetes?

When you are pregnant the placenta produces hormones that help your baby to grow and develop. These hormones also block the action of the mother's insulin. This is called insulin resistance.

Because of this insulin resistance, the need for insulin in pregnancy is 2 to 3 times higher than normal.

If you already have insulin resistance, then your body may not be able to cope with the extra demand for insulin production.

And the blood glucose (sugar) levels will be higher resulting in gestational diabetes being diagnosed.

Risk Factors May Increase Gestational Diabetes:

1. Have a family history of gestational diabetes.

2. Previously had Polycystic Ovary Syndrome.

3. You have had gestational diabetes during previous pregnancies.

4. Are from a Vietnamese, Chinese, middle eastern, Polynesian or Melanesian background.

5. Are from an Indigenous Australian or Torres Strait Islander background.

6. Are overweight or obese.

7. Are over 30 years of age.

8. Have a family history of Type II Diabetes.

Symptoms of Gestational Diabetes

When you are pregnant you will experience all types of changes both mentally and physically and the when it comes to Gestational diabetes there are often no real obvious symptoms.

The best way to see if you have gestational diabetes is to visit your doctor for some tests.

If symptoms do occur, they can include:

1. Unusual thirst
2. Excessive urination
3. Tiredness
4. Thrush (yeast infections)

Gestational Diabetes Video from American Diabetes Association

How Do They Diagnose Gestational Diabetes?

You will be advised by your doctor to have a pathology test which requires a blood sample to be taken before and after a glucose drink.

These tests are usually performed between 24 and 28 weeks into the pregnancy, or earlier if you are at high risk.

To diagnose gestational diabetes a pregnancy oral glucose tolerance test (POGTT) is recommended which involves taking a blood test after fasting overnight.

Next you have a drink containing 75 grams of glucose and blood is taken to be tested one and two hours afterwards.

Diagnosis of gestational diabetes is made if the fasting blood glucose is raised or the two-hour blood glucose is raised (or both).

What Happens Next if I Am Diagnosed with Gestational Diabetes?

Firstly, you will want to seek more information and your doctor will be your best resources to answer any specific questions you may have.

It is important to know that the majority of women with gestational diabetes have a healthy pregnancy, normal delivery and a healthy baby.

The treatment is healthy eating, physical activity and monitoring and maintaining a normal blood glucose level while you are pregnant.

Which is why PregActive takes a holistic approach to improving your overall health and wellbeing.

The Diabetes Team May Include:

The professional help you receive will depend on where you live and the medical services available. Often your antenatal care will include:

1. An endocrinologist who is a doctor that specializes in diabetes.

2. A diabetes educator who will educate you on how to monitor and manage your blood glucose levels.

3. A dietitian who will help you with a healthy food plan for your pregnancy.

4. Your doctor or General Practitioner (GP).

Gestational Diabetes Treatment

Gestational diabetes can often be managed with healthy eating and regular physical exercise or activity. For some women with gestational diabetes they will require daily insulin injections for the rest of the pregnancy.

The goal for Gestational diabetes treatment is to keep blood glucose levels equal to those of pregnant women who do not have gestational diabetes.

You will need help from your health care professional so that your treatment for gestational diabetes can be monitored, tested and changed as required.

By being able to successfully manage your gestational diabetes you will be increasing the likelihood of a healthy pregnancy as well as helping your baby avoid future poor health.

You will also be doing your part to avoid developing diabetes post-pregnancy and later on in life.

1. Eat a Healthy Diet

Eating a healthy diet when pregnant will benefit both you and your growing baby. Eating well combined with regular activity will also assist you in maintaining a health pregnancy weight.

You will want to consume foods rich in calcium, iron, and folic acid. You should also avoid foods and drinks containing a lot of added sugar.

Your Dietitian will be able to provide you with specific guidelines on what you should and should not be eating.

2. Exercise Regularly

You need to control your blood glucose levels. Be sure to check with your doctor before starting a new prenatal exercise program.

3. Maintain a Healthy Pregnancy Weight

Through healthy eating, exercising and making the right lifestyle choices can help you to maintain a healthy pregnancy weight.

It is only normal to gain weight when pregnant but what is not ideal is when you gain too much weight that directly impacts not only on your health but also that of your growing baby.

4. Monitor Glucose Levels

It is essential that you continue to monitor your blood glucose levels as it will help show you if the healthy lifestyle changes you have made are effective or whether further treatment is required.

5. Take Required Medication

You may be required to take regular insulin injections to help keep your blood glucose level in the normal range.

Why Does Gestational Diabetes Need To Be Treated?

If a mother's blood glucose levels are high then glucose passes through the placenta to the baby which may lead to the baby growing larger than the average baby.

Giving birth to larger babies can potentially cause more problems for both the mother and child during and following birth.

Another concern is that if gestational diabetes goes untreated then it can also lead to a greater likelihood of developing high blood pressure during the pregnancy which poses some additional health problems.

How Does Gestational Diabetes Affect the Birth?

Your diabetes will be continually monitored throughout the pregnancy using tests such as an ultrasound, blood glucose and blood pressure.

If your diabetes has been well managed and there are no other problems then you should be able to go 'full term' and give birth naturally.

This again will be based on the advice of your doctor for your specific situation.

If the baby grows too large or if your doctor has any other concerns about the pregnancy they may suggest 'inducing' the birth one or two weeks early.

Sometimes a caesarean may be required if the baby is too large or if there are other obstetric concerns such as low placenta, breech presentation or previous caesarean delivery.

What Happens after My Baby is Born?

For most women their blood glucose levels usually return to normal quite quickly after the baby's birth.

If you have been having insulin injections to help manage gestational diabetes, you can usually stop these injections once your baby is born. Your doctor will advise you on your specific situation.

Following the birth of your baby your blood glucose levels will be measured for a few days to ensure that they are within the normal range.

You will often be tested before breakfast and two hours after meals.

An Oral Glucose Tolerance test (OGTT) is done six to eight weeks after the baby is born to make sure that diabetes has gone away.

Following the birth of your baby, it is likely that your baby's blood glucose levels will also be measured to make sure that their blood glucose is not too low.

If it is, this can be treated by feeding your baby breast milk or formula.

Breastfeeding is encouraged as this is best for you and your baby.

A baby whose mother had gestational diabetes will not be born with diabetes, but, they may be at risk of developing type 2 diabetes later in life.

What Happens if I Want to Get Pregnant in the Future?

If you have been diagnosed with gestational diabetes you are more likely to have it again in future pregnancies.

Your doctor will be aware of this and will likely request that an OGTT (Oral Glucose Tolerance Test) be performed early in any future pregnancy to look for gestational diabetes.

If this test is normal, then another OGTT will be done again later in the pregnancy (22 and 28 weeks) to make sure blood glucose levels are still normal.

How Does A Healthy Eating Plan Help Manage My Gestational Diabetes?

When you eat a healthy diet you will be able to:

1. Manage your blood glucose levels within the target range advised by your doctor.
2. Provide adequate nutrition for you and your growing baby.
3. Achieve appropriate weight changes during your pregnancy.

How will a Dietitian Change My Diet?

A Dietitian will advise you on:

1. Which foods you should eat.
2. Which foods you shouldn't eat.
3. How much you should be eating.
4. How often you should eat.

The information in this post is for educational purposes only. It is not intended to replace the advice of your nutritionist, doctor or health care provider.

References Cited:

American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 36 (Suppl. 1):S67-S74, 2013

Villamor, E., and Cnattingius, S. 2006. Interpregnancy weight change and risk of adverse pregnancy outcomes: a population-based study. Lancet. 368:1164-70.

Olson, C.M., and Strawderman, M.S. 2003. Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain. J Am Diet Assoc. 103:48-54.

Catalano, P.M., and Ehrenberg, H.M. 2006. The short- and long-term implications of maternal obesity on the mother and her offspring. Bjog. 113:1126-33.

Mottola, M.F. 2008. The role of exercise in the prevention and treatment of gestational diabetes mellitus. Curr Diabet Reports. 8:299-304.