The mediating effect of e-health literacy on social support and behavioral decision-making on glycemic management in pregnant women with gestational diabetes: a cross-sectional study.

Background: Social support and e-health literacy are closely related to individual health behaviors, while behavior is premised on decision-making. Few studies have identified the relationships among social support, e-health literacy, and behavioral decision-making, and the nature of these relationships among pregnant women with gestational diabetes remains unclear. Therefore, this study aimed to investigate relationships among social support, e-health literacy, and glycemic management behavioral decisions in pregnant women with gestational diabetes. Methods: Using continuous sampling, an online cross-sectional survey was conducted among pregnant women with gestational diabetes who met the inclusion and exclusion criteria at four Class 3 hospitals in Fujian Province from October to December 2023. A structured questionnaire was used to collect data on general characteristics, socioeconomic status, social support, e-health literacy, and behavioral decision-making regarding glycemic management. Descriptive statistical analyses, correlation analyses, and mediation effects were used to assess associations. Results: A total of 219 pregnant women with gestational diabetes participated, and 217 valid results were obtained. The level of glycemic management behavior decision-making in women with gestational diabetes was positively correlated with e-health literacy (r = 0.741, p < 0.01) and with perceived social support (r = 0.755, p < 0.01). E-health literacy was positively correlated with perceived social support (r = 0.694, p < 0.01). The indirect effect of perceived social support on glycemic management behavior decisions through e-health literacy (a*b) was 0.153, accounting for 38% of the total effect. Conclusion: Social support and e-health literacy in pregnant women with gestational diabetes are related to behavioral decision-making in glycemic management. The results of this study provide a reference for developing targeted measures to improve glycemic management behaviors in pregnant women with gestational diabetes, which is crucial for achieving sustainable glycemic management.

Effects of moderate-intensity resistance exercise on blood glucose and pregnancy outcome in patients with gestational diabetes mellitus: A randomized controlled trial.

OBJECTIVES: To investigate the effects of a structured moderate-intensity resistance exercise program on blood glucose levels and other health-related indicators in patients with GDM. METHODS: A total of 99 patients with GDM in a tertiary class A general hospital were randomly divided into an experimental group and a control group. GDM patients in the control group received routine prenatal care, online education, and a personalized diabetes diet intervention. The experimental group was treated in the same way as the control group with the addition of a moderate intensity resistance exercise program. RESULTS: The blood glucose levels in both groups were lower after the intervention compared with before intervention (P < 0.05). After intervention, the average fasting blood glucose, the 2 h postprandial blood glucose, the utilization rate of insulin, the amount of insulin, gestational weight gain and blood pressure (P < 0.05) in the experimental group were lower than the control group. In addition, there was no statistical significance in the incidence of adverse pregnancy outcomes between the two groups after intervention (P > 0.05). CONCLUSIONS: Moderate intensity resistance exercise was helpful for improvement of blood glucose control and insulin use, gestational weight gain and blood pressure in patients with GDM. In the future, long-term follow-up of both maternal and newborn infants should be performed to assess the long-term effects of exercise intervention on maternal and child health. The impact on the risk of obesity and diabetes may need to be further clarified. The trial was approved by the registration of the Chinese Clinical Trial Registry, and registration number: ChiCTR1900027929.

Effects of Moderate-Intensity Aerobic Exercise on Blood Glucose Levels and Pregnancy Outcomes in Patients With Gestational Diabetes Mellitus: A Randomized Controlled Trial.

INTRODUCTION: To investigate the effects of structured moderate-intensity aerobic exercise on blood glucose, insulin, and pregnancy outcomes in patients with gestational diabetes mellitus (GDM). METHODS: One hundred one patients with GDM were randomly divided into a control group (50 cases) and an experimental group (51 cases) in a class 3 first-level general hospital. GDM patients in the control group received a personalized diabetes diet intervention, online education, and routine prenatal care. The experimental group added 6 weeks of moderate-intensity aerobic exercise in addition to the identical conditions given to the control group. The differences of fasting and 2-h postprandial blood glucose, insulin use, and adverse pregnancy outcomes were evaluated between the experimental and control group after intervention. RESULTS: Outcomes were available from 89 participants. Compared with before intervention, there were statistically significant differences in fasting blood glucose and 2-h blood glucose after three meals in both groups (P < 0.05). There were statistically significant differences in the average fasting blood glucose, the average 2-h postprandial blood glucose, the insulin dosage, and the utilization rate between the experimental and control group after the intervention (P < 0.05). Parameters in the experimental group were all lower than in the control group. Compared with the control group, the incidence of adverse pregnancy outcomes in the experimental group after intervention was not statistically significant (P > 0.05). CONCLUSION: Moderate-intensity aerobic exercise can help improve blood glucose control and insulin use in patients with GDM. In the future, long-term follow-up can be conducted for maternal and neonatal infants to evaluate the impact of exercise intervention on the risk of type 2 diabetes. CLINICAL TRIAL REGISTRATION: The trial was approved by the registration of the Chinese Clinical Trial Registry. Registration number: ChiCTR1900027929.

A meta-analysis of the effects of resistance training on blood sugar and pregnancy outcomes.

PROBLEM: There are different conclusions about the effects of resistance training on blood sugar levels and pregnancy outcomes in gestational diabetes mellitus (GDM) patients. BACKGROUND: Resistance training is recommended as an easier and more practical method to exercise for women with GDM due to their growing belly. Although some researchers have explored this notion, there are no consistent conclusions about its effects. AIM: To explore whether resistance training has an effect on blood sugar levels and pregnancy outcomes in patients with GDM in randomized controlled trials. METHOD: Pubmed, Cochrane Library, CINAHL, Embase, Scopus, Web of Science, Clinical Trials, CKNI, Wanfang Database, VIP Database, and Chinese Biomedical Literature Database were systematically searched since their establishment to April 2019. Relevant meta-analyses, reviews, and eligible literature were also searched. The quality of the included literature was evaluated according to the Cochrane Assessment Manual 5.1.0. Meta-analysis was performed using Revman 5.3 software. FINDINGS: A total of four studies (n = 242 patients) were included. Compared to the control group, there were statistical differences in fasting blood glucose level [MD=-0.37, 95%CI=(-0.65, -0.09), Z = 2.62, P = 0.009], average 2-h post-meal blood glucose level [MD=-0.96, 95%CI=(-1.80, -0.12), Z = 2.25, P = 0.02], insulin dosage [MD=-0.58, 95%CI=(-0.99, -0.17), Z = 2.75, P = 0.006], rate of insulin injection [RR=0.52, 95%CI=(0.31, 0.86), Z = 2.54, P = 0.01], and incidence of macrosomia [RR=0.15, 95%CI=(0.04,0.66), Z = 2.53, P = 0.01] in the intervention group consisting of GDM patients. There were no statistical differences in preterm delivery outcomes [RR=0.44, 95%CI=(0.09, 2.16), Z = 1.01, P = 0.31]. CONCLUSION: Resistance training can improve blood sugar levels, insulin usage, and some adverse pregnancy outcomes in patients with GDM and is therefore worthy of clinical promotion.