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Background Mothers with a history of gestational diabetes mellitus (GDM) have a high risk of progressing to type 2 diabetes mellitus (T2DM) in the future. This progression can be attenuated by appropriate lifestyle interventions. We aimed to understand the perceptions of mothers with GDM and their healthcare workers regarding postpartum physical activity with a view to design a lifestyle intervention programme. Methods We did this qualitative study in three selected districts of Sri Lanka. We also conducted six focus group discussions with 30 antenatal mothers with a history of GDM in a previous pregnancy, and six in-depth interviews with 3 postnatal nurses and 3 field midwives caring for postpartum mothers to explore their perceptions on postpartum physical exercises. Framework analysis was used to analyse the data. The transcripts were analysed using a Microsoft matrix and themes were generated. Results Eight themes related to physical exercises emerged from both groups of participants. Two themes, 'Myths regarding postpartum physical activity' and 'Lack of awareness of the importance of postpartum physical activity' emerged from both groups of participants. Three themes, 'Time pressure', 'Stigma' and 'Child demands' emerged only from mothers while three themes, 'Traditional and cultural beliefs', 'Lack of influence from healthcare workers' and 'Lack of motivation' emerged solely from healthcare workers. Conclusions The findings, especially the facilitators and barriers deserve the attention of health policy-makers when designing appropriate interventions to enhance postpartum physical exercises to attenuate the development of T2DM in women with GDM.

Background: Regular exercise is a key element in the management of type 2 diabetes mellitus (T2DM). Although the importance of regular exercises on glycemic control in people with diabetes is studied extensively, evidence is lacking on its impact on sweet taste perception. Thus, the aim of this study was to determine the impact of aerobic exercises on taste perception for sucrose in people with diabetes., Methods: A sample of 225 people with diabetes aged 35-60 years was assigned randomly into 3 groups; aerobic exercise, combined exercise and a control group. The outcomes of the combined exercise group is not reported. The aerobic exercise group performed brisk walking 30min/day, 4-5days/week for 6 months. The primary outcome measures were supra-threshold intensity ratings and preference for sucrose assessed at baseline, at 3 and 6 months using 'general Labeled Magnitude Scale' and 'Monell 2-series-forced choice method' respectively. Glycated haemoglobin (HbA1c) level was assessed at baseline and at 6 months to determine glycemic control., Results: Aerobic exercise group showed significantly increased ratings (mm) for higher sucrose concentrations at 3 months (mean difference for 2.02M; +6.63±2.50, p=0.048 and for 0.64M; +7.26±2.76, p=0.026) and at 6 months (mean difference for 0.64M; +7.79±4.49, p= 0.044) compared to baseline and also when compared to controls (mean difference for 2.02M between baseline and 3 months; intervention: +6.63±2.50, control: -4.01±1.79, p=0.02 and between baseline and 6 months for 2.02M; intervention: +3.15±0.57, control: -7.96±0.40, p=0.022 and for 0.64M; intervention: +7.79±4.49, control: -8.98±0.99, p=0.003). A significantly reduced preference (mol/L) was seen both at 3 (mean difference; -0.03±0.02, p= 0.037) and at 6 months (mean difference; -0.05±0.12, p=0.011) compared to baseline within the intervention group. Also, a significant reduction was seen in the intervention group compared to controls at 6 months (mean difference; intervention: -0.05±0.12, control: 0.01±0.03, p=0.044). HbA1c was significantly reduced in the intervention group compared to controls at 6 months (mean difference; intervention -0.43±1.6%, control +0.33±1.8%, p=0.018)., Conclusion: Regular aerobic exercises increase the sweet taste sensitivity, especially for higher concentrations of sucrose and decrease sweet taste preference in people with diabetes . These alterations in sweet taste perception, are likely to contribute to a better glycemic control in people with diabetes., Trial Registration: This trial was registered at the Sri Lanka Clinical Trial registry on 16/12/2015. (Trial registration number- SLCTR/2015/029 , https://slctr.lk/trials/slctr-2015-029)., (© 2022. The Author(s).)

Background: The link between sweet taste perception and carbohydrate intake in diabetics who perform regular combined exercises has not been explored. Aims and Objectives: This study aimed at determining the impact of combined exercises on taste perception for sucrose and carbohydrate intake in patients with type 2 diabetes mellitus. Materials and Methods: A clinical trial was conducted with 225 patients with T2DM, aged 35-60 years assigned randomly into three groups; aerobic, combined, and a control group. Outcomes of the aerobic group were not reported. Combined group performed brisk walking 4-5 days/week and resistance exercises 2-3 days/week for 6 months. Supra-threshold intensity ratings, preference for sucrose, and carbohydrate intake assessed at baseline, at 3 and 6 months were measured using "general Labeled Magnitude Scale," "Monell 2-series-forced choice method," and a 3-day diet diary, respectively. Results: Ratings for the highest (combined vs. control: +3.15±0.57 vs. -7.96±0.40 mol/L, P=0.022) and the second-highest sucrose concentrations (combined vs. control: +7.79±4.49 vs. -8.98±0.99 mol/L, P=0.003) in the combined group were significantly higher with significant time × group interaction (2.02M: P=0.002, 0.64M: P=0.003). Preference for sucrose was lower in the combined group (combined vs. control: -0.08±0.14 vs. +0.01±0.03 mol/L, P=0.002), and the time × group interaction was not significant. Carbohydrate intake (combined vs. control: -46.97±21.60 vs. -6.30±9.36 g, P=0.001) and HbA1c level (combined vs. control: -0.66±1.81 vs. +0.33±1.84%, P=0.008) were reduced in the combined group, and taste sensitivity significantly predicted the carbohydrate intake with combined exercises (R2=0.64, P=0.01). Conclusion: Regular combined exercises increase sweet taste sensitivity for higher concentrations of sucrose. Taste sensitivity, not the preference determines the carbohydrate intake in exercising diabetics. [ABSTRACT FROM AUTHOR]