Physical Activity Energy Expenditure and Glucose Control in Pregnant Women With Type 1 Diabetes
Is 30 Minutes of Daily Exercise Enough?
- Kavita Kumareswaran, MBCHB, FRACP, PHD1⇓,
- Daniela Elleri, MD1,
- Janet M. Allen, RN1,
- Karen Caldwell, RN1,
- Kate Westgate, BSC2,
- Soren Brage, PHD2,
- Philippa Raymond-Barker, MSC1,
- Marianna Nodale, MSC1,
- Malgorzata E. Wilinska, PHD1,
- Stephanie A. Amiel, PHD3,
- Roman Hovorka, PHD1 and
- Helen R. Murphy, MD, FRCP, PHD1
- 1University of Cambridge Metabolic Research Laboratories and NIHR Cambridge Biomedical Research Centre, Cambridge, U.K.
- 2Medical Research Council Epidemiology Unit, Addenbrooke’s Hospital, Cambridge, U.K.
- 3Diabetes Research Group, Kings College London, London, U.K.
- Corresponding author: Kavita Kumareswaran, .
OBJECTIVE To describe activity patterns in pregnant women with type 1 diabetes and evaluate the impact of increased structured physical activity on glucose control.
RESEARCH DESIGN AND METHODS Physical activity energy expenditure (PAEE) and glucose levels (continuous glucose monitoring) were measured in 10 pregnant women with type 1 diabetes (age 33.2 years, gestation 20 weeks, BMI 27.9 kg/m2, diabetes duration 16.6 years, HbA1c 6.5% [48 mmol/mol], insulin pump duration 2.4 years) during a day at home (free-living) and during a 24-h visit incorporating controlled diet and structured physical activity with light intensity activity (three 20-min self-paced walks) and moderate intensity activity (two 50-min sessions of brisk treadmill walking). PAEE was evaluated through individually calibrated combined heart rate and movement sensing.
RESULTS Free-living PAEE was comparable to that under controlled study conditions (3.8 and 5.1 kcal/kg/day, P = 0.241), with women achieving near to the recommended 30 min of moderate physical activity (median 27 min [interquartile range 14–68]). During the free-living period, more time was spent in light activity (10.3 vs. 7.2 h, P = 0.005), with less sedentary time (13.0 vs. 14.9 h, P = 0.047) and less moderate activity (27 vs. 121 min, P = 0.022). The free-living 24-h mean glucose levels by continuous glucose monitoring were significantly higher (7.7 vs. 6.0 mmol/L, P = 0.028). The effect of controlled diet and exercise persisted overnight, with significantly less time spent hyperglycemic (19% vs. 0%, P = 0.028) and less glucose variability (glucose SD 1.3 vs. 0.7 mmol/L, P = 0.022).
CONCLUSIONS A controlled diet and structured physical activity program may assist women with type 1 diabetes in achieving optimal glucose control during pregnancy.
- Received August 3, 2012.
- Accepted October 3, 2012.
- © 2013 by the American Diabetes Association.
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