(648) Device-based measures of postprandial physical activity and glucose in individuals with pregnancy hyperglycemia

Physical activity (PA) following meals is recommended for individuals with pregnancy hyperglycemia as a non-pharmacological strategy to manage postprandial glucose levels. The objective of the current study is to investigate this association specifically at the meal level, under free-living conditions and using repeated, device-based measures of both PA and glucose.

Study Design:
Fourteen subjects with gestational glucose intolerance (GGI) and 5 with gestational diabetes (GDM, not requiring insulin) participating in the Time to Move Randomized Crossover Trial (ClinicalTrials.gov #NCT06125704) provided data on 478 meals. Participants uploaded before and after photos of all eating and drinking episodes during the study period, designating them as a meal or snack; the timestamps on the before photos were used to identify the start times of all meals. Participants also wore Dexcom continuous glucose monitoring (CGM) devices and Actigraph CentrePoint Insight Watch PA monitoring devices. The Two-Regressions R package provided minute-by-minute estimates of the metabolic equivalent of task (MET). The associations of PA accumulated during the 1-hr postprandial period [i.e., total MET-minutes, dichotomized at the 75^th percentile] with 2-hr postprandial glucose metrics [i.e., mean and area under-the-curve (AUC)] were estimated with Proc Mixed in SAS v9.4, adjusting for GGI versus GDM.

Results:
PA accumulated during the 1-hr postprandial period at or above the 75^th percentile was associated with 3.6 mg/dl (SE 1.6) lower 2-hr postprandial mean glucose (P = .04), and 34787 (SE 12133) lower 2-hr postprandial glucose AUC (P = .01; results of the repeated measures analyses are presented in the Table). The 75^th percentile for PA accumulated during the 1-hr postprandial period was 111.15 MET-minutes, which corresponds to a threshold of approximately 37 minutes of moderate intensity walking.

Conclusion:
PA accumulated during the 1-hr postprandial period modestly reduces CGM assessed 2-hr postprandial glucose in individuals with pregnancy hyperglycemia.