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Cited by 141Gestational Diabetes Research and ManagementPhysical Activity and HealthDiabetes, Cardiovascular Risks, and Lipoproteins

Prevention of Gestational Diabetes

Open access
Callaway, Leonie K., Colditz, Paul B., Byrne, Nuala M., Lingwood, Barbara E., Rowlands, Ingrid J., Foxcroft, Katie, McIntyre, H. David, for the BAMBINO Group·2010·Diabetes Care
DOI 10.2337/dc09-2336PMC PMC2890340
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Abstract

OBJECTIVE: To examine the feasibility of an individualized exercise program to prevent gestational diabetes mellitus (GDM) in obese pregnant women. RESEARCH DESIGN AND METHODS: The study was a pilot randomized controlled trial with obese pregnant women (intervention group, individualized exercise program [n = 25]; control group, usual care [n = 25]). Average weekly energy expenditure (MET hours per week and kilocalories per week) of exercise-specific activity was assessed during pregnancy using the Pregnancy Physical Activity Questionnaire. Fasting glucose and insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were assessed at baseline and 20, 28, and 36 weeks' gestation. RESULTS: Of the women in the intervention group, 16 of 22 (73%) achieved more than 900 kcal/week of exercise-based activity at 28 weeks compared with 8 of 19 women in the control group (42%), P = 0.047. However, insulin resistance (HOMA-IR) did not differ between the groups. CONCLUSION: This intervention was feasible and prompted a modest increase in physical activity. However, we are not confident that this intervention would be sufficient to prevent GDM.

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  • Some studies show differences between groups in baseline characteristics such as blood glucose or socioeconomic level, both related to gestational diabetes.

    “Third, some of the studies show differences between groups in some of the baseline characteristics such as blood glucose or socioeconomic level, both factors related to the incidence of GDM [17, 19].”

    From A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity (2025) · cites this paper as [17]

    The Results (page not provided) say this trial had no statistically significant differences between groups in any baseline variable. Table 1 shows nearly identical baseline fasting glucose values (4.46 versus 4.47; P = 0.55). The copy does not report a socioeconomic-level difference between groups. (LLM, conf=0.86)

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  • The two trials that found no differences in physical activity level also found no effect on gestational diabetes.

    “in fact, the two trials [17, 21] that found no differences in physical activity level also found no effect on GDM.”

    From A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity (2025) · cites this paper as [17]

    The Abstract Results and Conclusions report a modest increase in physical activity in this trial, contrary to the claim that it found no difference. The Conclusions also say the study was not powered to examine GDM prevalence, so it cannot establish a null effect on GDM. (LLM, conf=0.88)

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  • In five studies sequence concealment was low risk; in two it was unclear.

    “Regarding the concealment of the sequence, in five studies sequence implementation was carried out by an independent person (low risk of bias) [16, 18, 19, 21, 22] and in two no information is presented [17, 20] (considered unclear risk because there was not enough information to allow an assessment of low risk or high risk).”

    From A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity (2025) · cites this paper as [17]

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  • In one trial, women in the control group voluntarily increased physical activity compared to that reported at recruitment.

    “This risk is reflected in one trial [17] in which it was observed that women in the control group voluntarily increased the physical activity they engaged in compared to that reported at recruitment.”

    From A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity (2025) · cites this paper as [17]

    The Conclusions report that women in the control group voluntarily undertook far more physical activity than predicted. They do not say their activity increased relative to what those women reported at recruitment; that comparator is unsupported. (LLM, conf=0.87)

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  • In three studies there was blinding of personnel analysing data (low risk); in the rest information was insufficient.

    “In three studies [18, 19, 21] there was blinding of the personnel analysing the data (low risk of bias), and in the rest of them there was not enough information to allow an assessment of low risk or high risk [16, 17, 20, 22].”

    From A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity (2025) · cites this paper as [17]

    The Research Design and Methods section describes the trial and its measurements but does not say whether personnel analysing the data were blinded. The Conclusions state that allocation was not concealed from participants, which is a different issue. Searches for blinded analysts and data-analysis blinding found no passage that establishes either the low-risk assessment or the stated insufficiency of information for this study; page numbers were unavailable in our copy. (LLM, conf=0.73)

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Cites

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Research works printed but not linked: 10

  1. [1]Chu SY Callaghan WM Kim SY Schmid CH Lau J England LJ Dietz PM: Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007; 30: 2070– 2076 17416786
  2. [2]Guelinckx I Devlieger R Mullie P Vansant G: Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutr 2009; 91: 373– 380 19955397
  3. [3]Colley RC Hills AP O'Moore-Sullivan TM Hickman IJ Prins JB Byrne NM: Variability in adherence to an unsupervised exercise prescription in obese women. Int J Obes (Lond) 2008; 32: 837– 844 18227844
  4. [6]Chasan-Taber L Schmidt MD Roberts DE Hosmer D Markenson G Freedson PS: Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc 2004; 36: 1750– 1760 15595297
  5. [7]Kirwan JP Huston-Presley L Kalhan SC Catalano PM: Clinically useful estimates of insulin sensitivity during pregnancy: validation studies in women with normal glucose tolerance and gestational diabetes mellitus. Diabetes Care 2001; 24: 1602– 1607 11522706
  6. [8]Hoffman L Nolan C Wilson JD Oats JJ Simmons D: Gestational diabetes mellitus–management guidelines. The Australasian Diabetes in Pregnancy Society. Med J Aust 1998; 169: 93– 97 9700346
  7. [10]Wolff S Legarth J Vangsgaard K Toubro S Astrup A: A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond) 2008; 32: 495– 501 18227847
  8. [11]Stage E Ronneby H Damm P: Lifestyle change after gestational diabetes. Diabetes Res Clin Pract 2004; 63: 67– 72 14693414
  9. [12]Guelinckx I Devlieger R Beckers K Vansant G: Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev 2008; 9: 140– 150 18221480
  10. [13]Evenson KR Moos MK Carrier K Siega-Riz AM: Perceived barriers to physical activity among pregnant women. Matern Child Health J 2009; 13: 364– 375 18478322 PMC2657195

Cited by

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Authors
Callaway, L. K., Colditz, P. B., Byrne, N. M., Lingwood, B. E., Rowlands, I. J., Foxcroft, K., McIntyre, H. D., & for the BAMBINO Group
Affiliations
  • The University of Queensland (AU)
  • Queensland University of Technology (AU)
  • Royal Brisbane and Women's Hospital (AU)
  • Mater Clinical School, School of Medicine, The University of Queensland, Brisbane, Australia.
Corresponding author
Foxcroft, Katie
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2010-03-31
Volume
33
Issue
7
Pages
1457-1459
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc09-2336
PMC
PMC2890340
OpenAlex
W2136132888
Cited by
141
References
3
Citations by year
2026: 5 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 7 · 2018: 14 · 2017: 6 · 2016: 13 · 2015: 13 · 2014: 11 · 2013: 15 · 2012: 17
FWCI
19.81
Type
journal article
Language
en
Open access
Licence
Locations
Diabetes Care (publishedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
gestational diabetes prevention, individualized exercise program, obese pregnant women, exercise during pregnancy, insulin resistance, HOMA-IR, energy expenditure, feasibility

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