Diagnosis to Delivery: A Randomized Clinical Trial of Postmeal Walking in Women with Gestational Diabetes.
Study Goal
The researchers aimed to determine if postmeal walking (PMW) is an effective and feasible alternative to standard continuous walking for managing gestational diabetes (GDM).
Results Summary
Postmeal walking did not improve postprandial glucose outcomes compared to standard care, with higher postprandial glucose at dinner in the PMW group. Both groups showed high adherence to prescribed physical activity, but PMW led to more sedentary time and less stepping time.
Population
Forty women with gestational diabetes (GDM) between 28 and 30 weeks of gestation.
Effective Dosage
Standard care (30-min continuous walking most days per week) or PMW (daily 10-min walks after three main meals).
Duration
Approximately 7 weeks.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
advice to perform postmeal walking (PMW) | no change | postprandial glucose outcomes | women with gestational diabetes (GDM) | - | did not improve | #1 |
advice to perform postmeal walking (PMW) | increase | mean 3 h postprandial glucose at dinner | women with gestational diabetes (GDM) | - | was higher | #2 |
advice to perform postmeal walking (PMW) | no change | 24-hour glucose | women with gestational diabetes (GDM) | - | were similar | #3 |
advice to perform postmeal walking (PMW) | no change | nocturnal glucose | women with gestational diabetes (GDM) | - | were similar | #4 |
advice to perform postmeal walking (PMW) | no change | fasting glucose | women with gestational diabetes (GDM) | - | were similar | #5 |
advice to perform postmeal walking (PMW) | increase | sedentary time | women with gestational diabetes (GDM) | ~57 min·d -1 | spent more time sedentary | #6 |
advice to perform postmeal walking (PMW) | decrease | stepping time | women with gestational diabetes (GDM) | ~11 min·d -1 | spent less time stepping | #7 |
prescribed 30 min·d -1 of physical activity accumulated as 3 × 10-min bouts | increase | adherence | women with gestational diabetes (GDM) | - | was high | #8 |
prescribed 30 min·d -1 of physical activity accumulated as one single bout | increase | adherence | women with gestational diabetes (GDM) | - | was high | #9 |
PURPOSE: The aim of this study was to determine whether advice to perform postmeal walking could be an effective and feasible alternate to standard care continuous walking for the management of gestational diabetes (GDM). METHODS: Forty women with GDM were randomized between 28 and 30 wk of gestation into either standard care (CTL; 30-min continuous walking, most days per week) or standard care with advice to PMW (daily 10-min walks after three main meals) for ~7 wk. The primary outcome for this randomized controlled trial was postprandial glucose assessed by continuous glucose monitors. Continuous glucose monitor and ActivPAL inclinometers (physical activity parameters) were each worn for 7 d at ~28 and ~35 wk gestation. Delivery outcomes were also collected. A linear mixed model compared the changes across time between groups. RESULTS: Twenty-six women (PMW: n = 12, CTL: n = 14; age 34 ± 5 y) completed the trial. Mean 3 h postprandial glucose at dinner was higher in the PMW versus CTL group at baseline and across the intervention (main effect group, P = 0.04). Twenty-four hours, nocturnal, and fasting glucose were similar between groups. The PMW group spent ~57 min·d -1 more time sedentary and ~11 min·d -1 less time stepping versus CTL (main effect group: P = 0.02 and 0.05). Adherence to the prescribed 30 min·d -1 of physical activity was high, regardless of whether accumulated as 3 × 10-min or one single bout of walking. CONCLUSIONS: Distributing activity as 10-min bouts after main meals did not improve postprandial glucose outcomes compared with standard-care control. More research on the optimal duration and intensity of postmeal walks to improve postprandial responses are needed. Strategies that mitigate sedentary time and increase the minutes of physical activity accumulated across the day in pregnancy are also warranted.