| Objective:Recently,since the high prevalence of diabetes and its increased lethality have been an international health challenge in various countries around the world,diabetes has placed considerable strain and burden on both physical health and government policies as a lifelong metabolic disease.A large number of researchers at home and abroad have proved through researches that exercise in the treatment of diabetes,which as one of the "5 carriages",is beneficial to the metabolic and physical abilities of people with diabetes,but it is necessary to explore and cooperate in how to improve exercise practice and efficiency and ensure exercise safety.This study is based on the combination of diabetes and medical clinic,using medical + exercise prescription,regular Nordic cane walking and health education tools,combined with the intelligent exercise prescription system and tracking device to carry out personalized comprehensive exercise intervention for patients with type 2 diabetes,aiming to explore and analyze the impact of exercise intervention on patients’ blood glucose,blood lipid,physical health indicators under the combined mode of physical therapist,so as to provide valuable reference for the innovation of diabetes health management system.Method:seventy-two patients with type 2 diabetes,aged 20-79 years,35 males and 37 females,from a hospital in Yangpu District,Shanghai were studied,and contraindications for exercise were excluded.In the form of a sitting clinic with a Endocrinologist,prior to the intervention,the patient’s dietary preference,exercise habits,and lifestyle such as interest were understood.The physical function and metabolic level were then checked by a physician,including blood pressure,heart rate,blood glucose,lipid,liver and kidney function,creatine kinase,myocardial enzyme spectrum,and the test of height,weight,BMI,body fat rate,waist circumference,based on blood glucose and lipid parameters of patients and body morphology,combined with their medication and lifestyle,to develop a one-year comprehensive intervention program,including personalized exercise prescription as the main content of the program,in addtion to the basic aerobic,strength,and flexibility sports,the Nordic walk-through are also covered.Implementing the process of tracking monitoring through the exercise bracelet,recording the number of steps and activity distribution.Patients were given a two week phase physical assessment and adjustment of their exercise prescription once every week after the start of the intervention,Scandinavian walking one to two times a week at a Park supervised by an exercise coaching staff,and health education was organized by medical andexercise specialists in a hospital every Wednesday.At the end of the intervention period,all the participants were tested again for body morphology index,blood glucose and lipid index,liver and kidney function index,creatine kinase index and cardiac enzyme spectrum index;the results of the two monitoring methods before and after the intervention were statistically analyzed to observe the impact of comprehensive exercise intervention on blood glucose,blood lipid and physical health of the patients under the combination of physical practitioner.Result:1.BMI,body fat rate and waist circumference of male and female participants were reduced before and after the intervention(P<0.05),which indicated that comprehensive exercise intervention had a significant effect on improving the body morphology of type 2 diabetes patients;2.The blood glucose levels of type 2 diabetes patients also decreased after the intervention,in which both male and female fasting blood glucose and HbA1 c were improved with difference(P < 0.05),and HbA1 c had a decreasing but not statistically significant difference,which indicated that comprehensive exercise intervention had positive effect on reducing blood glucose of type 2 diabetes patients;3.The levels of cholesterol and triglycerides of the patients were decreased before and after the comprehensive exercise intervention,and there was a statistically significant difference in the cholesterol decreasing trend of male subjects(P<0.05).Female sex was associated with statistically significant greater improvements in HDL-index relative to baseline,males had statistically significant decreases(P<0.05),and females had small increases in LDL-index relative to pre-intervention.It showed that comprehensive exercise intervention had a positive effect on the improvement of lipid indicators of patients.4.Before and after the comprehensive intervention,the patients’ liver and kidney function,creatine kinase index,and myocardial enzyme spectrum indicators were maintained with no abnormal changes,which showed the safeguard effect of the combination mode of physical therapist and physician on the safety of exercise process,and proved that the exercise did not cause liver and kidney and myocardial dysfunction,and no muscle damage during the implementation of the protocol;5.Through one year of exercise monitoring and tracking,the subject’s exercise habits remained good.The proportion of total daily walking average to moderate to high daily physical activity increased for most patients throughout the exercise execution,the distribution of activity and sleep time became more regular,and the adverse life time gradually improved.Conclusion:1.Comprehensive exercise intervention in combination with physical therapy significantly improved the body fat rate,BMI and waist circumference of patients with type 2 diabetes mellitus,and reduced the risk of metabolic syndrome;2.Comprehensive exercise intervention in combination with physical therapy improved the fasting blood glucose and HbA1 c levels of patients with type 2 diabetes,suggesting that the long-term regular exercise blood glucose control effect is obvious.3.Comprehensive exercise intervention in combination with physical therapyreduced the levels of triglyceride and cholesterol,regulated the content of high and low density lipoprotein,and promoted the improvement of blood lipid metabolism in patients;4.Implementing a combined medical outpatient clinic for comprehensive exercise intervention of diabetic patients an dynamically control the movement process,accurately adjust the exercise prescription,and effectively avoid the occurrence of sports risks.And through a variety of sports to improve the safety,scientific technology and interest of patients with type 2 diabetes,increase their active exercise and social participation,Achieved a closed-loop intervention model including comprehensive test assessment-exerciese tracking-feedback on information-retesting,innovating the medical treatment + exercise prescription for the combination of physical medicine and chronic disease management system. |
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