Relationship among Selected Factors, Exercises, and Two-hour Postprandial Blood Glucose Levels in Pregnant Women with Gestational Diabetes Mellitus
Article Sidebar
Main Article Content
Abstract
Purpose: To explore the relationship between selected factors and exercises, as well as between exercise and two-hour postprandial blood glucose levels in pregnant women with Gestational Diabetes Mellitus (GDM).
Design: A secondary analysis.
Methods: Through convenience sampling, a sample of 90 pregnant women with GDM was recruited from the antenatal units of Siriraj and Rajvithi Hospitals. Data were collected using personal information questionnaire, self-report exercise and blood glucose level record forms. Descriptive statistics and the correlation coefficients were used for data analysis.
Main findings: Factors significantly associated with exercises during pregnancy included hours of daily work outside a living place (p < .05), GDM classification (p < .05), and exercises before pregnancy (p < .05). Exercises before pregnancy was significantly associated with two-hour postprandial blood glucose levels (p < .01), whereas the exercise during pregnancy was not.
Conclusion and recommendations: The findings suggested that nursing interventions designed for decreasing blood glucose level should include promoting pregnant women with GDM doing exercises before and during pregnancy. Nurses should provide information about benefits and strategies to increase pregnantwomen’ confidence to perform exercises before and during pregnancy, especially women who had risk factors such as family history of diabetes, previous GDM, and aged over 30.
Article Details
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care 2005; 28(Suppl.1):S4-42.
Chanprapaph P, Sutjarit C. Prevalence of gestational diabetes mellitus in women screened by the glucose challenge test at Maharaj Nakorn Chiang Mai Hospital. J Med Assoc Thai. 2004;87(10):1141-6.
Sumeksri P, Wongyai P, Aimpun P.Prevalence of gestational diabetes mellitus in pregnant women aged 30 to 34 years old at Phramongkutklao Hospital. J Med Assoc Thai. 2006;89(4):S94-9.
Titapant V, Pimsen S, Kannikaklang N, Hansiriratanaskul N, Wuttiviboonchok W, Kongkaew S, et al. Annual statistical report 2007: Division of Obstetrics & Gynecologic Registry. Bangkok: Faculty of Medicine, Siriraj Hospital; 2007.
Silva JK, Kaholokula JK, Ratner R, Mau M. Ethnic differences in perinatal outcomes of gestational diabetes mellitus. Diabetes Care. 2006;29:2058-63.
Cunningham FG, Leveno KJ, Bloom SL, Hauth J, Rouse D, Spong CY. Williams Obstetrics. 23th ed. New York (NY): McGraw-Hill; 2010.
Ben-Haroush A, Yogev Y, Hod M. Epidemiology of gestational diabetes mellitus and its association with type-2 diabetes. Diabetic Med. 2004;21:103-13.
American Diabetes Association. Standards of medical care in diabetes-2010. Diabetes Care. 2011;33:S11-61.
American College of Obstetricians and Gynecologists. Pregestational diabetes mellitus: clinical management guidelines for obstetrician-gynecologists, Obstet Gynecol. 2005;60(March):105-675.
Pagano M, Luerssen M, Esposito E. Sustaining diabetes in pregnancy program: A continuous quality improvement process. Diabetes Educator. 2006;32:229-34.
Cheung NW, Smith BJ, Henriksen H, Tapsell LC, McLean M, Bauman A. A group-based healthy lifestyle program for women with previous gestational diabetes. Diabetes Res Clin Pr. 2007;77(2):333-4. 12. Crowther CA, Hiller JE, Moss JR, Mephee AJ, Jeffeies WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med.
;352:2477-86.
Garner P, Okun N, Keely E, Wells G, Perkins S, Sylvain J, Belcher J. A randomized controlled trial of strict glycemic control and tertiary level obstetric care versus routine obstetric care in the management of gestational diabetes: a pilot study. Am J Obstet Gynecol. 1997;177(1):190-5.
Pettitt D, Ospina P, Kolaczynski J, Jovanovic L. Comparisons of an insulin analog, insulin aspart, and regular human insulin with no insulin in gestational diabetes mellitus. Diabetes Care. 2003;26:183-6.
Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Canadian Diabetes Association 2003 clinical practice guidelines for the prevention and treatment of diabetes in Canada. Can J
Diabetes. 2003;169:S1-152.
Sigal RJ, Kenny G, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American
Diabetes Association. Diabetes Care. 2006;29:1433-8.
American College of Obstetricians and Gynecologists. Exercise during pregnancy and the postpartum period (ACOG committee opinion no. 267). Obstet Gynecol. 2002;99:171-3.
Schmidt MD, Pekow P, Freedson P, Markenson G, & Chasan-Taber L. Physical activity patterns during pregnancy in a diverse population of women. J Womens
Health. 2006;15(8): 909-18.
Tumilehto J, Lindstrom J, Eriksson JG, Valle TT, Hamalainen H, Ilanne-Parikka P, et al. Prevention of type 2 diabetes mellitus by change in lifestyle among subjects with impaired glucose tolerance. N Engl J Med.
;1344:1343-50.
Jovanovic-Peterson L, Durak EP, Peterson CM. Randomized trial of diet versus diet plus cardiovascular conditioning on glucose levels in gestational diabetes. Am J Obstet Gynecol. 1989;161:1415-9.
Artal R, Wiswell A, Romen Y. Hormonal responses to exercise in diabetic and nondiabetic pregnant patients. Diabetes. 1985;34(Suppl 2):S78-80.
Avery MD, Walker AJ. Acute effect of exercise on blood glucose and insulin levels in women with gestational diabetes. J Matern Fetal Med 2001; 10(1):52-8.
Redden SL, LaMonte MJ, Freudenheim JL, Rudra CB. The association between gestational diabetes mellitus and recreational physical activity. Matern Child Health J.
;15(4):14-9.
Yimjaidee T. Reduction of diabetic pregnant women needing insulin therapy by a systematized management diabetic pregnant women before and after management
system modification. Obstretic and Gynecology Department, Faculty of Medicine, Siriraj Hospital; 2001. (in Thai)
Sunsaneevithayakul P, Ruangvutilert P, Sutanthavibul A, Kanokpongsakdi S, Boriboohirunsarn D, Raengpetch Y, et al. Effect of 3-day intensive dietary theraphy during admission in women after diagnosis
of gestational diabetes mellitus. J Med Assoc Thai. 2004;87(9):1022-8.
Charoenparakul S. Effect of endurance exercises with resistance, in gestational diabetes mellitus class A1, on blood glucose levels (Thesis). Bangkok: Chulalongkorn University; 2001. 100 p. (in Thai)
Burns N, Grove SK. The practice of nursing research: Conduct, critique, and utilization. 5th ed. St. Louis (MO): Elsevier; 2005. 28. Limruangrong P, Sinsuksai N, Ratinthorn A, Boriboonhirunsarn D. A self-regulation
program on diet and exercise behaviors in pregnant women with gestational diabetes mellitus (Thesis). Bangkok: Mahidol University; 2011. 125 p.
National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1997; 28:1039–57.
Fell DE, Kephart G, Curtis LJ, Bower K, Muhajarine N, Reid R, Roos L. The relationship between work hours and utilization of general practitioners in four Canadian provinces. Health Serv Rep. 2007;42(4):1483-98.
Symons-Downs D, Ulbrecht J. Understanding exercise beliefs and behaviors in women with gestational diabetes mellitus. Diabetes Care. 2006;29(2):236-40.
Thorén P, Foras JS, Hoffmann P, Seals DR.Endorphins and exercise: Physiological mechanisms and clinical implications. Med Sci Sport Exer. 1990;22(4):417-28.
Tobias D, Zhang C, VanDam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: A meta-analysis. Diabetes Care. 2011;34(1):223-9.
Redden SL, LaMonte MJ, Freudenheim JL, Rudra CB. The association between gestational diabetes mellitus and recreational physical activity. Matern Child Health J.
;15(4):514-9.