Effect of physical activity on placental glucose transporter expression in women with early gestational diabetes (eGDM): a secondary analysis of the randomised clinical trial

OBJECTIVES: Glucose is the primary energy substrate for the developing foetus, and placental glucose transport is a key element of pregnancy physiology. In early gestational diabetes mellitus, metabolic alterations may disrupt the expression of glucose transporters (GLUTs). This study evaluated the influence of physical activity, monitored using pedometers, on the expression of the SLC2A1 (GLUT-1), SLC2A3 (GLUT-3), and SLC2A4 (GLUT-4) genes in the placentas of women with early gestational diabetes, and analysed associations between GLUT expression and clinical parameters. MATERIAL AND METHODS: Fifteen women with early gestational diabetes were enrolled in the study and divided into an intervention group (using pedometers) and a control group. Clinical, anthropometric, and biochemical parameters were assessed across each visit. Placental glucose transporter mRNA expression was evaluated using RT-qPCR. RESULTS: No statistically significant differences in GLUT-1, GLUT-3, and GLUT-4 expression levels were observed between groups; however, a trend toward lower glucose transporter expression was noted in the intervention group. GLUT-1 expression correlated positively with subscapular skinfold thickness and systolic blood pressure at the first visit (V1). In contrast, GLUT-4 expression showed a strong negative correlation with glycated haemoglobin (HbA1c) and body mass at the second and third visits (V2, V3). No significant differences in obstetric and neonatal outcomes were found between the groups. CONCLUSIONS: Regular physical activity, as measured by pedometers, may influence the molecular regulation of placental glucose transporters in women with early gestational diabetes. Further studies with larger cohorts are needed to confirm these observations and to assess the long-term impact on offspring health.