Gestational Diabetes Mellitus Clinical Trial
Official title:
Effects of Structured Exercise Regime for the Management of Gestational Diabetes Mellitus (GDM) - Bio Psychosocial Perspectives.
Rehabilitation in the field of Obstetrics is an emerging field worldwide although it is still
very much neglected in a country like Pakistan. Increasing prevalence of GDM has highlighted
the importance of rehabilitation in this specific area. In USA upto14% of pregnancies get GDM
problem, 6.8 to 10.4 % in China while in India 27.5% which is exceptionally high. Similarly
in Pakistan it has become a common issue.
Many observational studies have been done to find the risk factors and causes of GDM. However
to the best of investigator's knowledge no experimental study have been done so far on the
effects of exercise on physical, physiological and psychological aspects of GDM. Hence a
randomized control trial is planned on diagnosed GDM patients in Fauji Foundation Hospital
Rawalpindi who will recieve supervised structured exercise regeme for 5 weeks and their data
will be recorded using reliable tools at the baseline and after 5 weeks to assess the effects
of exercise.
GDM is a medical condition of high maternal glucose level which is diagnosed only when women
are pregnant and overcome after pregnancy. It results in various maternal and neonatal
complications like caeserean delivery in mothers and obesity in children. Women having GDM
have greater risk of diabetes and cardiovascular problems later in life which is threatening
for us. Obese women are at increased risk of developing GDM and it is also a risk factor for
developing high blood pressure and protein in the urine after 20 weeks of pregnancy that
condition is known as preeclampsia.
Many studies have shown that physically active women are less prone to develop GDM as compare
to those women who have sedentary life style which draws attention towards the role of
antenatal exercises for prevention and management of GDM and has become the first line
treatment in developed countries. In addition to obesity and sedentary life style other known
risk factors are family history, age of mother and number of children but there is no
definite single cause of GDM yet discovered.
Exercises programs during pregnancy are not usually practiced in our population and routine
domestic activities are considered as enough for fitness. We have a common myth that pregnant
women should not do treadmill or stationary cycle or any other aerobic activity which is
really wrong and resulting in problems like GDM. Women following moderate exercise programs
during their pregnancy have reported reduction in daily insulin administration dosage in
comparison with women not doing any prescribed exercise. As Gestational weight gain is a
major risk factor for GDM, exercises have given evidence to facilitate weight reduction.
Exercise programs prescribed by physical therapists during pregnancy for preventing and
managing GDM are considered useful and recommended by researchers and practitioners around
the world but in developing countries like Pakistan, women are not receiving this method of
treatment due to lack of awareness in general public, lack of referral system from
gynaecologists and obstetricians and unavailability of women health Physical therapists in
hospital set ups.
This study will provide data showing the effects of exercise in biomarkers level and give the
option of treatment to obstetricians.
This will fill the research gap in the area of rehabilitation in GDM. This will also
highlight the importance of women health physical therapists in obstetric conditions as there
is less awareness of this speciality in Pakistan.
This will provide the data regarding which type, intensity and duration of exercise should be
recommendable while treating GDM.
This study will open new doors for researchers to do long term studies on different
biomarkers with different exercise types.
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