Steps Versus Strength: Which Exercise Better Controls Glucose in Gestational Diabetes Mellitus? A Literature Review
DOI:
https://doi.org/10.37287/ijghr.v8i6.2926Keywords:
blood glucose, gestational diabetes, physiotherapy, pregnancy, resistance training, walkingAbstract
Gestational diabetes mellitus (GDM) ranks among the metabolic disorders most often seen in pregnancy, and guidelines advise exercise alongside medical nutrition therapy as an early treatment step. Walking and resistance exercise are the two most accessible modalities for pregnant women, yet which of them better controls maternal glucose remains unclear. This review set out to contrast how walking-based and resistance exercise influence glucose control in women with GDM and to translate the findings into practical recommendations for physiotherapy practice. A literature review with a systematic approach based on PRISMA 2020 was conducted in PubMed, the Physiotherapy Evidence Database (PEDro) and Google Scholar, covering records available until October 2026; the included studies were published between 2004 and 2024. Eligibility followed the PICOS framework; parallel-group or crossover randomised trials and prospective controlled studies that delivered walking or resistance exercise to women with GDM and measured glucose-related outcomes were synthesised narratively. Fourteen studies from Canada, Brazil, Iran, Egypt, China, the United States, Denmark, Poland and Australia were included: seven walking-based, four resistance-based and three head-to-head comparisons. Four themes emerged: (1) resistance trials reduced insulin requirement and fasting glucose, and resistance exercise consistently lowered fasting and postprandial glucose; (2) walking lowered postprandial glucose when performed as a sustained or brisk interval bout after meals, whereas short 10-minute post-meal bouts were no better, or even worse, than continuous walking; (3) in head-to-head studies, resistance exercise produced equal or greater reductions in 2-hour postprandial glucose with better adherence, while combined walking and resistance exercise achieved the lowest HbA1c; and (4) both modalities were safe and feasible at home. Resistance exercise appears to provide more consistent glycaemic control over weeks, particularly in reducing insulin requirement, whereas walking is a useful acute strategy for postprandial glucose. A combination of both is recommended, although larger trials are still needed.
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