Understanding Gestational Diabetes - Exercise

Should I exercise?

A daily exercise program is an important part of a healthy pregnancy. Daily exercise helps you feel better and reduces stress. In addition, being physically fit protects against back pain, and maintains muscle tone, strength and endurance. For women with gestational diabetes, exercise is especially important.

• Regular exercise increases the efficiency or potency of your body's own insulin. This may allow you to keep your blood sugar levels in the normal range while using less insulin.
• Moderate exercise also helps blunt your appetite, helping you to keep your weight gain down to normal levels. Maintaining the correct weight gain is very important in preventing high blood sugar levels.

Talk with your doctor about what exercise program is right for you. Your doctor can advise you about limitations, warning signs, and any special considerations. Generally, you can continue any exercise program or sport you participated in prior to pregnancy. Use caution, however, and avoid sports or exercises where you might fall, or that involve jolting. Pre-pregnancy bicycling, jogging and cross-country skiing are good exercises to continue during pregnancy. If you plan to star an exercise program during pregnancy, talk to your doctor before beginning and start slowly. Vigorous walking is good for women who need to start exercising and have not been active before pregnancy.

An ACOG report*, issued in 1985, warned that target heart rates for pregnant and postpartum women should be set approximately 25 to 30 percent lower than rates for non-pregnant women. It may be that exercising too vigorously will direct blood flow away from the uterus and fetus. ACOG recommends that pregnant women measure their heart rate during activity and that maternal heart rate not exceed 140 beats per minute.

If you need to be on insulin during your pregnancy, take a few precautions. Because both insulin and exercise lower blood sugar levels, the combination can result in hypoglycemia or low blood sugar. You need to be aware that this is a potential problem and you should be familiar with the symptoms of hypoglycemia (confusion, extreme hunger, blurry vision, shakiness, sweating). When exercising, take along sugar in the form of hard, sugar-sweetened candies just in case your blood sugar becomes too low. When on insulin, you should always carry some form of sugar for potential episodes of hypoglycemia.

It may be necessary for you to eat small snacks between meals if the exercise results in low blood sugar levels.

• One serving of fruit will keep blood sugars normal for most short-term activities (approximately 30 minutes).
• One serving of fruit plus a serving of starch will be enough for activities that last longer (60 minutes or more).

If you exercise right after a meal, eat the snack after the exercise. If the exercise is 2 hours or more after a meal, eat the snack before the exercise.

Food and Exercise Worksheet

*Home Exercise Program: Exercise During Pregnancy and the Postnatal Period. American College of Obstetricians and Gynecologists, May 1985, 6pp.