Background: Women diagnosed with gestational diabetes mellitus (GDM) are at substantially increased risk of
developing type 2 diabetes and obesity, currently at epidemic rates in the United States. GDM, therefore,
identifies a population of women at high risk of developing type 2 diabetes and provides an opportunity to
intervene before the development of this disorder. It is well recognized that acute as well as chronic physical
activity improves glucose tolerance in type 2 diabetes. To date, however, primary prevention trials have not been
conducted to test whether an increase in physical activity reduces risk of developing GDM among women at
high risk of this disorder.
Methods: The aims of this study are to investigate the effects of a motivationally targeted, individually tailored
12-week physical activity intervention on (1) development of GDM, (2) serum biomarkers associated with insulin
resistance, and (3) the adoption and maintenance of exercise during pregnancy. Women at high risk of GDM are
recruited in early pregnancy and randomized to either an individually tailored exercise intervention or a
comparison health and wellness intervention.
Results: The overall goal of the exercise intervention is to encourage pregnant women to achieve the American
College of Obstetricians and Gynecologists guidelines for physical activity during pregnancy through increasing
walking and developing a more active lifestyle.
Conclusions: The intervention takes into account the specific social, cultural, economic, and physical environmental
challenges faced by pregnant women of diverse socioeconomic and ethnic backgrounds.