**8. Application of a pedometer for the management of impaired glucose tolerance in pregnant women**

It is reasonable to assume that walking quantified by a pedometer is beneficial for the management of impaired glucose tolerance not only in non-pregnant subjects but also in pregnant subjects. Dahjio et al. reported a study on pedometer-monitored walking for the management of glucose in non-pregnant individuals. They examined a 12-week aerobic exercise training program monitored with a pedometer in type II diabetic Cameroonian women [33]. The subjects showed a significant reduction in body weight, waist circumference, and mean glycaemia after 12 weeks of the program. However, no study so far has reported the use of a pedometer in pregnant women with impaired glucose tolerance. Hence, we examined the feasibility of using a pedometer to quantify the exercise intensity and the relationship between the amount of exercise and carbohydrate metabolism in pregnant women with impaired

#### **Figure 1.**

*Citizen digital pedometer TW700, connected to a laptop computer. The pedometer was connected to a laptop computer through a USB cable to upload steps.*

**141**

*significant.*

**Table 1.**

**Figure 2.**

Relation between no. of steps and pre-prandial blood glucose level immediately following walking

Relation between no. of steps and postprandial blood glucose level immediately following walking

Relation between total no. of steps per day and blood glucose level

Relation between no. of steps per day and following day FBS

Relation between no. of steps and change in blood glucose level

before and after

*Application of a Pedometer for the Management of Impaired Glucose Tolerance in Pregnant…*

glucose tolerance employing a pedometer (Citizen Digital Pedometer TW 700 with high-sensitivity 3D acceleration sensor, CITIZEN SYSTEMS JAPAN CO., LTD, Japan) by which the recorded data of number of steps are stored chronologically for 30

*Comparison of number of steps and blood glucose levels in 1-day based (from Ref. [34], with permission).*

*FBS: Pre-breakfast blood glucose, AB: After-breakfast blood glucose, BL: Pre-lunch blood glucose, AL: After-lunch blood glucose, BD: Pre-dinner blood glucose, AD: After-dinner blood glucose, vds: Bedtime blood glucose, n.s.: not* 

*DOI: http://dx.doi.org/10.5772/intechopen.93953*

*An example of the uploaded step data into a spreadsheet of Microsoft Excel.*

**Correlation coefficient**

−0.02 n.s.

−0.01 n.s.

−0.08 n.s.

No. of steps, morning & BL −0.12 n.s. No. of steps, afternoon & BD 0.28 n.s. No. of steps, night & vds 0.25 n.s.

No. of steps, morning & AB 0.06 n.s. No. of steps, afternoon & AL 0.02 n.s. No. of steps, night & AD 0.03 n.s.

Total no. of steps per day & vds 0.06 n.s.

No. of steps, morning & AB-BL −0.12 n.s. No. of steps, afternoon & AL-BD −0.24 n.s. No. of steps, night & AD-vds −0.05 n.s.

Insulin: yes 0.003 n.s. Insulin: no −0.03 n.s.

Total no. of steps per day & following day FBS

No. of steps, night & AD-following day FBS

> Total no. of steps per day & following day FBS-FBS

**P value**

*Application of a Pedometer for the Management of Impaired Glucose Tolerance in Pregnant… DOI: http://dx.doi.org/10.5772/intechopen.93953*


**Figure 2.**

*Sugar Intake - Risks and Benefits and the Global Diabetes Epidemic*

smartphone pedometer instead of stand-alone pedometer.

**tolerance in pregnant women**

16 to 20 weeks of gestation in overweight and obese women. The average number of steps after the intervention was over 10,000, along with the intake of 2000 kcal/day. This approach resulted in the prevention of excessive weight gain as well as excessive postpartum weight retention [31]. The study clearly demonstrated that both nutritional and exercise interventions are necessary in order to achieve reasonable outcomes in the management of glucose metabolism in obese pregnant women. In comparison of a smartphone pedometer with a reference pedometer, The Yamax Digiwalker, Tokyo, Japan, a smartphone pedometer is even superior at a low walking speed, suggesting a smartphone pedometer might be superior to pregnant women who are not expected to walk faster. [32]. So, there is no problem in using a

**8. Application of a pedometer for the management of impaired glucose** 

*Citizen digital pedometer TW700, connected to a laptop computer. The pedometer was connected to a laptop* 

It is reasonable to assume that walking quantified by a pedometer is beneficial for the management of impaired glucose tolerance not only in non-pregnant subjects but also in pregnant subjects. Dahjio et al. reported a study on pedometer-monitored walking for the management of glucose in non-pregnant individuals. They examined a 12-week aerobic exercise training program monitored with a pedometer in type II diabetic Cameroonian women [33]. The subjects showed a significant reduction in body weight, waist circumference, and mean glycaemia after 12 weeks of the program. However, no study so far has reported the use of a pedometer in pregnant women with impaired glucose tolerance. Hence, we examined the feasibility of using a pedometer to quantify the exercise intensity and the relationship between the amount of exercise and carbohydrate metabolism in pregnant women with impaired

**140**

**Figure 1.**

*computer through a USB cable to upload steps.*

*An example of the uploaded step data into a spreadsheet of Microsoft Excel.*


*FBS: Pre-breakfast blood glucose, AB: After-breakfast blood glucose, BL: Pre-lunch blood glucose, AL: After-lunch blood glucose, BD: Pre-dinner blood glucose, AD: After-dinner blood glucose, vds: Bedtime blood glucose, n.s.: not significant.*

#### **Table 1.**

*Comparison of number of steps and blood glucose levels in 1-day based (from Ref. [34], with permission).*

glucose tolerance employing a pedometer (Citizen Digital Pedometer TW 700 with high-sensitivity 3D acceleration sensor, CITIZEN SYSTEMS JAPAN CO., LTD, Japan) by which the recorded data of number of steps are stored chronologically for 30


#### **Table 2.**

*Comparison of average number of steps per day and all data items (from Ref. [34], with permission).*

consecutive days [34]. The data stored in the pedometer are transferred through USB port of the computer and analysed chronologically (**Figures 1** and **2**). In a 24-hour time frame, there was no correlation between the number of steps walked and pre- or postprandial blood glucose level immediately after walking, nor between the average number of steps per day and the fasting blood glucose level on the next day (**Table 1**). However, the 4-week data showed that there was a negative correlation between the number of steps per day and the change in HbA1c levels (**Table 2**). Moreover, there was a negative correlation between the average number of steps per day and change in the maternal body weight (**Table 2**). A 1-week based data from the subjects administered with insulin indicated that there was a negative correlation between the average number of steps per day and the total amount of insulin administered per day. Our results indicated that pedometer-monitored walking improved insulin resistance without affecting blood glucose levels just after the bouts of walking. In addition, carrying the pedometer may have self-promoting effect for sustaining the exercise for the women with impaired glucose tolerance by noticing the improvement in the changes in the body weight and HbA1c levels in response to her steps walked. To conclude, our report was the first to show the usefulness of a pedometer for the management of IGT in pregnant women. We plan to continue studying this issue in future studies with higher numbers of participants along with nutritional counselling. Further studies are anticipated in order to design appropriate pedometer-monitored exercise plans not only for the management of IGT in pregnant women but also for that of the obese pregnant women. Nowadays, so many kinds of applications for pregnant women dealing with weight control, nutrition, foetal movement, maternal heart rates, it would be worthwhile to develop applications for incorporating pedometer data with body weight, maternal heart rate, ultrasound foetometric data and the parameters of the blood glucose control for the women with impaired glucose tolerance.

**143**

**Author details**

, Mitsue Muraoka2

Medical Center East, Tokyo, Japan

3 Saigusa Maternity Clinic, Tokyo, Japan

provided the original work is properly cited.

\*Address all correspondence to: kotak0821@gmail.com

and Koichiro Takagi3

1 Department of Obstetrics and Gynecology, Tokyo Women's Medical University

2 Department of Obstetrics and Gynecology, Shiseikai Daini Hospital, Tokyo, Japan

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

\*

Mariko Ueno1

*Application of a Pedometer for the Management of Impaired Glucose Tolerance in Pregnant…*

With the widespread use of smartphones equipped with pedometer function, walking exercises are easily monitored and utilised not only in normal but also in pregnant women with obesity and impaired glucose tolerance. Furthermore, data including footsteps, and pulse rates if smart watch will be used together with smartphone and information of the foetal growth, comprehensive management of the exercise and body weight control will be achieved. Further studies are expected to assess how many steps per day and how many bouts are optimal for the best

We would like to thank Editage (www.editage.jp) for English language editing.

*DOI: http://dx.doi.org/10.5772/intechopen.93953*

blood sugar and body weight control during pregnancy.

**9. Conclusion**

**Acknowledgements**

**Conflict of interest**

No conflict of interest exists.

*Application of a Pedometer for the Management of Impaired Glucose Tolerance in Pregnant… DOI: http://dx.doi.org/10.5772/intechopen.93953*
