Exercise therapy, an important way to control blood glucose in diabetic patients, also has a lot to say about rough exercise, which does not work very well. Diet therapy, medication, exercise therapy, blood glucose monitoring and diabetes education are called the five horsemen of diabetes treatment. Exercise therapy not only improves the blood sugar level of diabetic patients, but also helps to reduce weight, control blood lipids and blood pressure, and reduce complications. When people with diabetes are exercising, certain details may be relevant to the effectiveness of exercise therapy and should not be ignored! Typical case] 42-year-old Mr. Liu, who has been diagnosed with type 2 diabetes for 1 month, jogged for half an hour every morning on an empty stomach for exercise. [Interpretation] When exercising on an empty stomach in the early morning, the body’s ability to maintain blood sugar is limited, and it is easy to induce hypoglycemia, especially in patients who are using hypoglycemic drugs; the blood viscosity in the early morning is high, and the risk of thrombosis increases, and it is also the peak period of heart attack. So early morning exercise on an empty stomach is a misconception. Blood sugar is relatively high about one hour after eating, and hypoglycemia is less likely to occur, so it is appropriate to exercise one hour after meal (timing from the first bite). At the beginning of exercise therapy, it can be 5~10 minutes each time, and gradually extend to 20~30 minutes or even 60 minutes each time as the body adapts to exercise. Before each exercise should be 5 ~ 10 minutes of preparatory activities, after exercise at least 5 minutes of relaxation activities. It is recommended that obese patients exercise for 30-60 minutes per session, and patients with wasting, gestational diabetes and over 70 years old exercise for 20-30 minutes per session. At the same time, exercise should be consistent. If the exercise interval is more than 3~4 days, the exercise effect and cumulative effect is reduced. If the amount of exercise each time, can be 1-2 days, but do not exceed 3 days, if each exercise is small and the body allows, it is ideal to exercise once a day. Typical case] Diabetic patient Ms. Wang, 56 years old, playing badminton as a form of exercise, shortness of breath during exercise, heart rate 128 times / min, fatigue after exercise. The intensity of exercise for type 2 diabetic patients actually has “degrees” to follow. Exercise with low intensity is mainly fat-burning; exercise with moderate intensity has a significant effect on lowering blood sugar. Moderate intensity exercise is most suitable for people with type 2 diabetes. There are three “degrees” to measure moderate intensity exercise: ① no shortness of breath when exercising; ② can continue to exercise for 10~30 minutes, slightly sweating, slightly tired but can persist; ③ no fatigue when waking up on the second day. Medium-intensity exercise usually includes walking, jogging, cycling, swimming, tai chi, etc. Among them, walking should be preferred. Among them, walking should be preferred. In addition, the heart rate during exercise is also a measure of “degree”. Subtracting age from 170 is often used as the appropriate heart rate during exercise, and the heart rate during exercise should ideally be at or near this heart rate. For example, the case of the patient’s age 56 years old, the appropriate heart rate for exercise 170-56 = 114 times / min, while her heart rate reached 128 times / min, along with shortness of breath, fatigue, so badminton for her is “excessive” exercise. Typical case] Ms. Song has been suffering from type 2 diabetes for many years, and she takes a walk as a way to exercise, but she can’t stick to it for a long time. [Interpretation] exercise, when the supply and demand for oxygen is in balance, called aerobic exercise, most of the medium-intensity exercise belongs to aerobic exercise. Aerobic exercise in a single form, such as jogging, walking, cycling, swimming, etc., although it can lower blood sugar to a certain extent, consume fat and improve cardiopulmonary function, but long-term adherence is not boring (as in the case). If you can combine resistance training, you can increase the pleasure of exercise. Resistance training refers to the active exercise performed by muscles in overcoming external resistance, which also has a hypoglycemic effect. Resistance training can be performed with dumbbells, elastic bands, and mineral water bottles filled with water or sand, and patients with better joint condition can also consider stair climbing or rope skipping. Resistance training can be done three times a week for 20-30 minutes each time, spaced with aerobic exercise. Typical case] Mr. Tong, 55 years old, had type 2 diabetes for 10 years, combined with diabetic retinopathy, with active fundus hemorrhage, and had a sudden retinal detachment after swimming one day. [Interpretation] Hypoglycemia, worsening heart disease, increased proteinuria in patients with nephropathy, retinal detachment in diabetic retinopathy, etc. may occur during exercise therapy in diabetic patients, which is caused by neglecting exercise safety. To ensure safety, exercise should be temporarily stopped in the following cases: ① fasting or postprandial blood glucose > 14 mmol/L, obvious hypoglycemia or diabetic ketoacidosis: ② diabetic retinopathy patients with active fundus hemorrhage; diabetic nephropathy patients with stage IV or above; ③ diabetic patients with cardiac or pulmonary insufficiency; ④ diabetic patients with lower limb gangrene or ulcerated infection. The above contraindications to exercise should be paid attention to before exercise and evaluated under the guidance of physicians; during and after exercise, attention should also be paid to the presence of hypoglycemic symptoms such as weakness and sweating, and supplemental sugar to above 5.5 mmol/L if the blood glucose value is <5.5 mmol/L. Before and after exercise, the foot should be examined for blisters or injuries. In patients with combined diabetic retinopathy, the load of resistance exercise should not be too large, and avoid lowering the head, holding the breath, swimming, etc. When exercising, it is best to travel in a group and carry candy, cookies and other food, as well as a diabetic card with name, age, main disease, address and contact phone number, etc., in case of emergency.