Abstract
PURPOSE: This study aimed to examine the overall impact of randomized controlled trials (RCTs) assessing the effects of exercise interventions-considering program duration, timing, and type-on blood glucose control in women with gestational diabetes mellitus (GDM), thereby improving the reliability of evidence in this field. METHODS: For this systematic review and meta-analysis, we searched major international and domestic databases (PubMed, Embase, Cochrane, CINAHL, RISS, DBpia, NSDL, and KISS) for RCTs published up to December 2024 in English or Korean. Participants were pregnant women diagnosed with GDM. Interventions involved exercise for blood glucose management, while the control group received routine care. The outcome variables were blood glucose levels, including fasting blood sugar (FBS), 2-hour postprandial glucose (PPG2hr), and glycated hemoglobin (HbA1c). Fifteen studies were selected and analyzed using a random-effects model, with mean difference (MD) and 95% confidence interval (CI). RESULTS: Glycemic parameters in the exercise group improved significantly compared with those in the routine care group: FBS, -0.47 mmol/L (n=963; MD=-0.47; 95% CI, -0.69 to -0.24; p<.001), PPG2hr, -0.62 mmol/L (n=944; MD=-0.62; 95% CI, -0.84 to -0.40; p<.001), and HbA1c, -0.39% (n=259; MD=-0.39; 95% CI, -0.53 to -0.25; p<.001). CONCLUSION: Exercise intervention is an effective strategy for regulating blood glucose levels in women with GDM. Moreover, engaging in exercise approximately 15 minutes after meals and scheduling sessions 7 to 10 times per week may be more effective than current recommendations of at least 30 minutes of exercise three times weekly.