The effect of social Nervous (SaSo) exercise with insulin resistance (HOMA-IR) on gestational diabetes mellitus among Indonesian pregnant women: a quasi-experimental study

Background: Gestational diabetes mellitus (GDM) is a carbohydrate intolerance condition that is diagnosed for the first-time during pregnancy and is associated with various adverse pregnancy outcomes for both mother and child, such as increased rates of perinatal complications and long-term morbidity. Exercise is a strategy to reduce hyperglycemia experienced during gestational diabetes mellitus. One type of exercise that can be done is a social nervous exercise (SaSo). SaSo can stimulate the parasympathetic or myelinated vagus nerves and control blood glucose by stimulating autonomic nerves system so that nerve homeostasis and glucose homeostasis occur. This study aimed to determine the impact of a SaSo program consisting of warm-up, core (prayer movements) and cool-down exercises on glucose homeostasis (HOMA-IR) parameters in women with GDM. Methods The study used a quasi-experimental design. Thirty-seven women with GDM at 24-28 weeks gestation were divided into an experimental group (n=19) with a regularly supervised SaSo program (n=18). The control group received only standard antenatal care for GDM. The exercise program started from the time of diagnosis of diabetes to six weeks of intervention conducted twice per week with sessions lasting 40-45 minutes. Bivariate analysis was used to test the difference in means with pretest and posttest results. Results Majority of pregnant women were in the not at-risk age category for control and intervention groups (79% and 83%, respectively). The baseline data results for the experimental and control groups were homogeneous, with no difference in baseline variables ( P >0.05). The social nervous exercise experimental group had lower mean difference (MD±SD) levels of insulin resistence in late pregnancy compared to the control group (-9.15±10.06 vs 3.42 ±14.84) ( P =0.004). Conclusions A social nervous exercise program has a beneficial effect on insulin resistance (HOMA-IR) levels in late pregnancy. Further research needs to be done with larger studies to confirm the findings of this study. Trial registration: Ethical approval was obtained from the Medical and Health Research Ethics Committee of the Faculty of Medicine, Universitas Gadjah Mada Yogyakarta (KE/0978/08/2019).