Researchers propose Nintendo Wii gaming to control gestational diabetes in women

Goal is to see whether the women get more exercise and thereby lower their blood glucose levels and decrease the need for insulin

Many women have trouble finding time to exercise in their busy lifestyles. That's especially true for pregnant women who live in northern climates such as Canada, where the weather can limit outdoor activity during winter months every year.

But exercise is critical to managing gestational diabetes, a growing problem that occurs in 2 to 9 per cent of pregnancies.

Researchers at St. Michael's Hospital have proposed a novel solution. They want to offer women recently diagnosed with gestational diabetes a Nintendo Wii gaming console, a Wii Fit activity platform and two activity-promoting games, Wii Sport and Wii Fit Plus. The goal is to see whether the women get more exercise and thereby lower their blood glucose levels and decrease the need for insulin.

"We all know how hard it is to maintain a proper exercise regimen in the best of times. It is obviously much harder while pregnant. We thought that by combining a fun, home-based activity with a clinical goal we will be able to achieve an important health benefit for our patients with gestational diabetes," said Dr. Howard Berger, head of the high-risk pregnancy unit at St. Michael's.

Women usually have a blood test for gestational diabetes when they are 24 to 28 weeks pregnant. The treatment is diet and exercise, such as 20-30 minutes of walking a day. If that doesn't control their blood glucose levels, they have to take insulin, which happens in 15 to 66 per cent of women with gestational diabetes.

Women with gestational diabetes are at increased risk of developing diabetes and obesity later in life. They are also at increased risk of developing complications during pregnancy and delivery, including heavier babies, pre-eclampsia, premature births, higher rates of Cesareans and post-partum hemorrhage. Newborns of a diabetic mother may also suffer from metabolic complications including hypoglycemia (low blood glucose) and hyperinsulinemia, a condition also known as pre-diabetes.

Study participants will be patients at the hospital's diabetes in pregnancy clinic, part of the Women's Health Centre, which today moves back to 61 Queen St. E. following a $6.3 million renovation of their fourth- and fifth-floor offices and exam room and the building lobby.

"Our new ambulatory center for women strives to treat women as a whole, offering the most appropriate care for their individual situation and incorporating the most recent advances in health care practice and technology," said Dr. Guylaine Lefebvre, chief of obstetrics and gynecology.

The renovations include bigger examining rooms, where the patient will remain while various health care professionals come to her, and bigger ultrasound rooms, with space for partners and relatives to be present. The architect for the project was from Diamond + Schmitt Architects, who also designed the hospital's new Li Ka Shing Knowledge Institute.

St. Michael's specializes in high-risk pregnancies and serves the inner city population, including at-risk women.

• We have the only obstetrical trauma unit in the Greater Toronto Area
• We are the only hospital in Canada performing robotic myomectomies, a minimally invasive technique for removing uterine fibroids
• We pioneered the use of an infant passport, a portable health record and information booklet for young pregnant homeless or other marginalized women, which offers incentives to seek prenatal care