Author: Wang Jianhua
Unit: Director of Jinan Diabetes Clinic
< p>Source: Medical Endocrinology Channel
Benefits of Exercise
Just like diet therapy and drug therapy, exercise therapy is an integral part of the overall diabetes treatment. Scientific and reasonable exercise can enhance physical fitness, improve cardiopulmonary function and immunity.
Exercise can also reduce weight, improve insulin resistance, and help lower blood sugar in people with diabetes(especially postprandial blood sugar), reduce the dosage of hypoglycemic drugs.
even milder patients with early type 2 diabetes can Without hypoglycemic drugs, only through diet control and exercise treatment, blood sugar can be controlled to normal levels.
Although exercise has many benefits for people with diabetes, not all people with diabetes are suitable for exercise. For diabetic patients with severe complications or blood sugar fluctuations, mindless exercise may aggravate the condition, and vice versa.
Furthermore, just moving your body doesn’t necessarily bring benefits. If you just move casually and casually, you will definitely not achieve the expected exercise effect, but if you blindly pursue the intensity of exercise and ignore your own tolerance, it will also cause harm to the body.
So, which patients are suitable for exercise? What project should I choose? How exactly should you exercise? There is actually a lot of knowledge here. Only by paying attention to science, reasonable arrangements, different from person to person, and perseverance, can we truly achieve the purpose of strengthening the body and preventing diseases.
1 Preparation before exercise
To ensure the safety of exercise, you should do:< /p>
1. Go to the hospital for a comprehensive physical examination.
Check items include blood glucose, glycosylated hemoglobin, Blood pressure, electrocardiogram, fundus, renal function, electrocardiogram and cardiac function, etc., to check for cardiovascular, neurological and other complications.
You can discuss with the doctor whether the current condition is suitable for exercise, which exercise is more suitable, and the amount of exercise. And what to pay attention to when exercising.
Generally speaking, people with the following 7 conditions are not suitable for physical exercise:
acute complications or infection; p>
Has proliferative retinopathy;
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Have diabetic foot ulcers;< /p>
Recent myocardial infarction, stroke, combined cardiac insufficiency, diabetic nephropathy and massive proteinuria;
Poor blood pressure control, such as systolic blood pressure greater than 160mmHg or diastolic blood pressure greater than 100mmHg;
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Poor blood sugar control or large blood sugar fluctuations.
2. Check your feet carefully before each exercise and choose shoes and socks that fit your feet.
Special attention should be paid to the smoothness of the soles, no sand, stones foreign objects such as.
3. Carry the “diabetes emergency card” with you when exercising.
The name, contact information of family and friends should be written on the card, State your condition. In the event of an accident, it is convenient for others to take first aid measures and help contact the patient’s family.
4. Carry sugary foods with you.
Such as candy bars, chocolates, cookies, sweet drinks, etc. in case of hypoglycemia urgently needed.
5. It is best to exercise together.
Let your peers know that you are a diabetic if How to deal with unexpected situations.
2 Reasonable choice of exercise method
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Exercise is divided into “aerobic exercise” and “anaerobic exercise”, which are mainly determined by the oxygen metabolism in the body.
“Cardio”(also known as “endurance exercise”), as the name suggests, is exercise performed under aerobic conditions, which means that it can enhance the inhalation of oxygen in the body, Endurance exercise for transport and utilization is characterized by low intensity, rhythm, and long duration. It can enhance cardiopulmonary function, improve metabolism, and help lower blood sugar and blood lipids.
Aerobic activities suitable for diabetics includewalking, jogging, cycling, climbing, Aerobics, ballroom dancing, Tai Chi, swimming, rowing, etc., patients can choose according to their own conditions and hobbies.
“anaerobic exercise” refers to the High-speed and intense exercise in a state of “hypoxia” is characterized by a very low intake of oxygen during exercise, and has to rely on “anaerobic energy supply”, such as sprinting, weightlifting and other competitions Sexual exercise,This type of exercise can promote the secretion of glucocorticoid in the body, which in turn raises blood sugar.
Walking is the safest, easiest, and most consistent way of walking, and is considered to be the best option for older adults with diabetes(especially for those with poor physical fitness)‘s preferred sport.
Fitness running is a moderate-intensity exercise, suitable for diabetic patients with good physique and no cardiovascular disease.
Of course, diabetics can also combine their interests , Actual illness, physical condition, environmental conditions and other specific conditions, choose a suitable exercise method according to local conditions, for example, people living in high-rise buildings can perform stair climbing, rope skipping, running in place and other sports.
3 Scientifically determine the amount of exercise
Diabetes patients must exercise moderately.
Excessive exercise intensity is not only prone to hypoglycemia, Moreover, it will increase the burden on the heart and be harmful to the body; if the exercise intensity is too small, the purpose of exercising and controlling blood sugar will not be achieved. Therefore, it is important to scientifically determine the amount of exercise.
There are 3 ways to assess the appropriateness of exercise intensity:
1. “Conversation test” method.
This is an easy way to measure exercise intensity. When you are exercising, you can still talk naturally, indicating that the exercise intensity is moderate.
2. “Self-feeling” method.
Insufficient physical activity: No sweat, no fever, no change in heart rate after exercise, or recovery within 2 minutes of rest.
Appropriate amount of exercise: Slight sweating after exercise, relaxed and happy; slight fatigue, which can disappear after rest, and full of energy the next day.
Excessive exercise: sweating, chest tightness, shortness of breath after exercise; very tired, pulse does not return 15 minutes after rest , the next day the whole body is exhausted.
3. “Suitable heart rate” method.
Know yourself by counting your pulse immediately after exercise Is the exercise intensity appropriate. If the pulse during exercise(times/min) reaches “170-age”, it means that the exercise intensity is appropriate.
For example , a 50-year-old patient, the appropriate heart rate during exercise is about 120 beats/min(170-50). In addition, pay attention to changes in blood pressure, exercise intensity should not exceed 180 mm Hg systolic blood pressure.
4 Timed, Quantitative Movement
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The purpose of exercise therapy is to cooperate with diet and hypoglycemic drugs to control blood sugar levels. Therefore, exercise should not be done at will, and the exercise time, exercise intensity and exercise frequency should be relatively fixed as much as possible.
1. Fixed time.
diabetic patients should maintain a relatively constant amount of time per exercise . Most scholars believe that 1 hour after a meal is the best time for diabetic patients to start exercising, because the blood sugar level in the body is relatively high during this period, exercise is not easy to cause hypoglycemia, and Great for lowering blood sugar.
Note:
Diabetes patients should not exercise on an empty stomach, especially if they are taking hypoglycemic drugs(or insulin injections) Exercise before meals to avoid hypoglycemia.
2. Fixed strength.
The intensity of exercise should be relatively fixed, which can reduce blood sugar fluctuations , to prevent hypoglycemia.
3. Fixed frequency and duration.
The American Diabetes Prevention Study shows that weekly Exercise for at least 150 minutes is more suitable for diabetic patients. If the time is too short, the desired effect will not be achieved, and if the time is too long, it is easy to damage the skeletal muscles. Schedule at least 5 days a week, each exercise for about 30 minutes.
Of course, young patients with good physique can extend the exercise time appropriately, while the elderly and infirm can reduce it. Avoid not exercising on weekdays, and save too much exercise at one time on weekends.
5 Gradual and consistent
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Should follow a step-by-step principle, starting with a low amount of exercise(<40% of maximum oxygen consumption ), and the duration is 5~10min. If the patient feels good and can continue to adapt to exercise, then gradually enter into moderate-intensity exercise(50%~60% of maximum oxygen consumption) span>.
Difficulty breathing, chest pain during and after exercise If you have symptoms such as pressure, dizziness, headache, and pale complexion, you should stop exercising immediately, and in severe cases, you should be sent to the hospital for diagnosis and treatment as soon as possible.
In addition, no matter what type of exercise you do, you must persist for a long time to make it a conscious effort in your daily life. Behavior. “Three days of fishing and two days of netting” will not achieve the effect of exercise. There is data to show that the improved insulin sensitivity disappears after 3 days of cessation of exercise.. Therefore, exercise therapy should be implemented at least 3 times a week.
6 Warm up before exercise and relax after exercise
To ensure safe movement, the Warming up and post-workout cleaning are essential steps.
1. Warm up.
sports Do 5~10 beforeMinutes of low-intensity aerobic warm-up, for example, do some stretching before running, then walk slowly for 5-6 minutes, then gradually increase the pace. The purpose is to gradually increase the exercise intensity, improve the adaptability of the cardiovascular system to exercise, and improve the flexibility of joints and muscles, so as to avoid muscle strain due to exercise. However, avoid breath holding as it can raise systolic blood pressure.
2. Relax and organize.
A large amount of blood collects in the musculature of the limbs during exercise. If you stop exercising suddenly, the blood cannot return to the heart quickly, resulting in temporary cerebral ischemia, causing symptoms such as dizziness, nausea and even collapse. Therefore, do not stop exercising suddenly, do at least 5~10 minutes of finishing exercise, make the heart rate return to the level of 10~15 beats per minute higher than resting time, and then stop and rest. For example, after jogging for 20 minutes, gradually change to brisk walking, slow walking, stretching, kicking, and then walking home to rest.
7 Prevention and management of hypoglycemia during exercise
Exercise can consume energy and lower blood sugar, but sometimes exercising on an empty stomach can also cause hypoglycemia. Follow the following principles:
1. Exercise 1-2 hours after meals as much as possible, when blood sugar is higher than high, and thus less prone to hypoglycemia.
2. Do not choose the thigh and other parts as the insulin injection site as much as possible, because the blood flow of the part that is vigorously exercised during exercise will be reduced. Increased insulin absorption can lead to hypoglycemia.
3. Avoid fasting exercise as much as possible.
4. If you want to do moderate or more intense exercise and last for a long time, you can appropriately reduce the pre-exercise hypoglycemic drugs >(including insulin) dosage, and appropriate meals before and during exercise.
5. If possible, you can measure blood sugar with a blood glucose meter once before and after exercise. In order to know how much exercise is appropriate, it will not cause hypoglycemia.
6, If during or after exercise If symptoms of hypoglycemia such as hunger, palpitation, cold sweats, dizziness, and weakness of limbs appear, stop exercising immediately and take the food you bring with you. Mild hypoglycemia usually relieves symptoms after resting for about 10 minutes. If it fails to relieve, you should eat again and be escorted to the hospital by someone else immediately.
Summary
Exercise therapy emphasizes individualization, different Individuals of age and physique vary in their choice of exercise methods and intensity, and neither insufficient nor excessive exercise is advisable. In addition, the three principles that the movement must abide by are “step by step”, “according to one’s capabilities” and “perseverance”.
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