| Objective: Type 2 diabetes mellitus（T2D）and its complications are heavy burden on the family and society.Exercise is now recommended as first lime treatment T2 D,however,it into daily healthcare practice is a slow and complex pursuit.The purpose of this study is to explore the impact of exercise rehabilitation carried out in the hospital on glucose and lipid metabolism and health-related physical fitness of T2 D patients,to offer some suggestions for future application of exercise for T2 D into the healthcare practice.Methods: Based on the inclusion and exclusion criteria,36 patients with T2 D were randomly divided into control group and exercise group.The control group received routine T2 D treatment（standardized diabetes medication,dietary guidance and health education）.The exercise group received exercise rehabilitation in hospital on the basis of routine treatment scheme（one 90 minutes training session includes 20 minutes warm-up and stretching,30 minutes of moderate-intensity cardio and 40 minutes resistance training,in total of 90 minutes,three times per week）.The treatment period was 12 weeks.Blood glucose,blood lipid and fitness were measured before,after 6 weeks and 12 weeks respectively.The intra-and inter-groups differences before and after intervention were analyzed.Paired sample t-test was used for intra-group comparison,two factor repeated measurement analysis of variance was used for intergroups comparison,and chi square test was used to compare the control rate.Results:（1）There was no significant difference of any indicators between the exercise group and control group at the baseline.（2）Paired-samples T-test showed that after 6 weeks of intervention,in the exercise group,fasting blood glucose,Hb A1 c and HOMA-IR significantly decreased（p < 0.05）,and further decreased after 12 weeks（p < 0.05）.However,there were no significant changes in glucose metabolism in the control group before and after intervention.Two factor repeated measurement ANOVA showed that,controlling for the baseline level,compared with the control group,Hb A1 c in the exercise group decreased significantly after 6 and 12 weeks of intervention（p < 0.05）.After the intervention,the blood glucose control rate in the exercise group increased from 33.3% to 73.3%.（3）Paired-samples T-test showed that after 6 and 12 weeks of intervention,triglyceride,total cholesterol and low-density cholesterol in the exercise group decreased significantly（p < 0.05）;Only after 12 weeks,high-density cholesterol increased significantly（p < 0.05）.Further,triglyceride and low-density cholesterol decreased further（p < 0.05）,and high-density cholesterol increased（p < 0.05）.For the control group,after 6 and 12 weeks,low-density cholesterol decreased significantly（p< 0.05）,high-density cholesterol increased significantly（p < 0.05）,while other indexes had no significant changes before and after intervention.Two factor repeated measurement analysis of variance showed that there was no significant difference in the changes of lipid metabolism indexes between the two groups.（4）Paired-samples T-test showed that after 6 weeks of intervention,the body fat percentage in the exercise group decreased significantly（p < 0.05）,and the grip strength,lower limb extension and lower limb flexion increased significantly（p < 0.05）;After 12 weeks,the body fat percentage decreased further（p < 0.05）,and the grip strength,lower limb extension and lower limb flexion increased further（p < 0.05）.After 12 weeks,the peak oxygen uptake in the exercise group increased significantly（p < 0.05）.Two factor repeated measurement analysis of variance showed that controlling for the baseline level,after 6 weeks of intervention,the body fat percentage of the exercise group decreased significantly and the grip strength increased significantly;After 12 weeks of intervention,the body fat percentage in the exercise group decreased significantly,and the grip strength,lower limb extension,lower limb flexion and maximum oxygen uptake increased significantly.Conclusion: In-hospital exercise rehabilitation has a good clinical effect on T2 D,which can effectively improve the blood glucose and lipid metabolism,and enhance the health-related physical fitness of T2 D patients.In-hospital exercise rehabilitation can provide an example for future application of exercise for T2 D into the healthcare practice. |
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