The Improvement Of Glycemic Level Of Surgical Inpatients With Type 2 Diabetes Mellitus Through Preoperative Short-Term Exercise

Objective1、This study was to observe the change of glycemic level of surgical inpatients with type 2 diabetes mellitus(T2DM)before and after short-term exercise in the preoperative preparation stage.2 、 To explore the influence of different intensity exercise programs on preoperative glycemic in suigically inpatients with T2 DM and to provide a reasonable preoperative exercise nursing strategy for such patients.Methods1、Thirty surgically patients with T2 DM who were admitted to the general surgery of a third-grade class-A hospital in Beijing were selected from March 2017 to December 2017 and were randomly divided into exercise group(15 cases)and control group(15 cases)according to the random number table method.Then preoperative routine care with preoperative eduction,diabetes education and fixed-point glycemic monitoring was performed on the control group,while a 5 days period to set the frequence,intensity,time and type of the exercise intervention based on preoperative routine care was performed on the exercise group during which 24-hour continuous glucose monitoring system(CGMS)was performed within 1 day after hospitalized to assess the basic glycemic conditions.Biochemical examination to assess the glycemic metabolism include the FPG,PPG and Fins.At the same time,the HOMA-IR,InIAI and HOMA-β were calculated.In order to observe the changes of glycemic in the two groups.The above indicators were retested after the intervention.2、A total of 51 patients with T2 DM who were undergoing surgery and were admitted to the general surgery of a third-grade class-A hospital in Beijing from January 2018 to December 2018 and were randomly divided into mediumintensity intermittent exercise group,low-intensity continuous exercise group and control group according to the random number table method.The control group only performed preoperative basic care(the methods is same to the first part).Under the same conditions,patients in the exercise group were underwent exercise intervention with different intensity for 5 days.In order to observe the changes of basic glycemic in the three groups,the indicators of the basic glycemic were evaluated by CGMS for 5 days in a raw.The biochemical examination was used to evaluate the glycemic metabolism in the three groups of patients before and on the 3rd and 5th day after the intervention(the monitoring index is same to the first part).Results1、(1)After 5 days of intervention,only the MBG,SDBG and PPG of the control group were improved compared with those at admission(P<0.05).In addition to Gmin,the glycemic metabolism and basal glycemic indexes of the exercise group were improved compared with those before the intervention(P<0.05).(2)After 5 days of intervention,the glycemic compliance rate of the exercise group was higher than that of the control group(P<0.05).2、(1)During the 5 days of intervention,the basic indicators of glycemic of the control group began to improve on the 4th day after the intervention(P<0.05).In the low-intensity continuous exercise group,the two indicators Gmax and LAGE were improved on the 2nd day(P<0.05),and the other indicators were significantly different on the 3rd day,after the intervention(P<0.05).In the medium-intensity intermittent exercise group,the MBG,SDBG and CV were improvement on the 2nd day(P<0.05),and the other indicators were significantly different on the 3rd day,after the intervention(P<0.05).(2)After 3 days of intervention,the patients with moderate-intensity intermittent exercise in the glycemic metabolism index had better improved PPG,Fins,lnIAI and HOMA-IR than those in the control group(P<0.05),and also improved Fins(P<0.05)more than those in the lower-intensity continuous exercise group.After 5 days of intervention,the moderate-intensity intermittent exercise group was significantly improved in the overall level of glycemic metabolism compared with the control group(P<0.05),and those were improved in the PPG,Fins,InIAI and HOMA-IR compared with the lower-intensity continuous exercise group(P<0.05).(3)After 3 days of intervention,the overall compliance rate of glycemic in the exercise group was higher than that in the control group(P<0.05).Conclusions1、Short-term exercise intervention has a positive influence on preoperative glycemic control of inpatients with type 2 diabetes mellitus.2、The 3 days preoperative moderate-intensity intermittent exercise has improved the comprehensive glycemic condition of surgically inpatients with type 2 diabetes mellitus.