W.A. Qazi1, M.N. Babur2, A.N. Malik3, R. Begum1
1Foundation University, Institute of Rehabilitation Sciences, Islamabad, Pakistan, 2Isra University, Isra Institute of Rehabilitation Sciences, Islamabad, Pakistan, 3Riphah International University, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
Background: Prevalence of Gestational Diabetes Mellitus has been increasing globally but in developing countries like Pakistan the incidence is increasing at an alarmingly high rate. Literature provides evidence regarding high values of Cholesterol, low density lipoproteins, High density lipoproteins, triglycerides and c reactive protein in women with gestational diabetes mellitus. Different studies have focused on preventing and managing risks for the development of gestational diabetes through exercises but the actual effects of particular type of exercise with specific dosage on different biomarkers during second and third trimester is still need to be determined.
Purpose: To evaluate the effects of antenatal aerobic exercise on lipid profile including low density lipoproteins, high density lipoproteins, cholesterol and triglycerides and on inflammatory marker including C reactive protein in patients with gestational diabetes mellitus
Methods: This two arm randomized control trial was conducted at rehabilitation department of Fauji Foundation Hospital Rawalpindi from April 2019 till January 2020 on the sample of 70 diagnosed Gestational diabetes mellitus patients through oral glucose tolerance test. Patients were of age between 20 to 40 years and gestational age from 20 to 36 weeks. While patients with type 1 diabetes, severe breathlessness on Borg scale, pregnancy induced uncontrolled hypertension and with history of premature births were excluded. Sample size was calculated by using open epi tool. Participants were randomly allocated into two groups (n=35) via sealed envelope method. Both groups were receiving oral hypoglycemic drugs and diet plans along with postural education. While the patients in intervention group individually received 5 weeks of exercise program under the supervision of physical therapists including aerobics of moderate intensity using stationary cycle (10 min; MET 1-3) and brisk walk (10 min) in addition of routine antenatal exercises. Total three sessions per week of 40 min duration at the gym and gynae ward. Demographics were taken on self-structured questionnaire while values of lipid profile and C reactive protein from the reports of blood samples tested and verified in laboratory of hospital were recorded at base line and then after 5 weeks sessions. Data was analyzed by using SPSS 20.
Results: Mean age was 30.5 ± 3.17 years in interventional group while in control group it was 33.0 ± 4.30 years. After analysis between two groups, serum Low Density Lipoproteins showed significant difference (p<0.05) while for High Density Lipoproteins, Cholesterol Total and triglycerides there was no significant difference (p>0.05). For C reactive protein both groups showed no significant difference (p >0.05) at baseline but after five weeks of interventions significant difference (p<0.05) was observed.
Conclusion(s): The antenatal aerobic exercise had a positive influence in reducing inflammatory marker i.e. C reactive protein and low density lipoproteins in patients with gestational diabetes mellitus patients.
Implications: The findings of this study can be utilized in developing countries where exercises are not routinely practiced specially during high risk pregnancies like gestational diabetes mellitus. Supervised antenatal aerobic exercises with medical and dietary interventions should be a part of interdisciplinary management to reduce inflammation and low density lipoprotein levels.
Funding, acknowledgements: No funding was required
Keywords: C reactive protein, gestational diabetes mellitus, low density lipoproteins
Topic: Pelvic, sexual and reproductive health
Did this work require ethics approval? Yes
Institution: Foundation University Medical College
Committee: Ethical Review Committee
Ethics number: FF/FUMC/215/Phy/18
All authors, affiliations and abstracts have been published as submitted.
