A survey shows that, as of last year, China’s diabetic patients reached 113 million, and one in every 3-4 diabetics in the world is from China. It can be seen that sugar control has become a matter of urgency, and in the process of sugar control, exercise therapy is a very important means. Diabetic exercise is beneficial to increase the use of glucose by muscle tissue to achieve the purpose of lowering blood sugar. But what principles should diabetics follow when exercising? Today I will tell you what diabetic patients should pay attention to in exercise.
Precautions before exercise
First of all, you should decide how, when and how much to exercise according to your personal situation. Before implementing an exercise program for diabetic patients, it is best to go to the hospital for a comprehensive and systematic examination, including blood pressure, blood sugar, glycosylated hemoglobin, electrocardiogram, fundus, kidney function and other tests. Sometimes a cardiac function test is also necessary. Patients should establish a good relationship with their doctors and ask them to develop a reasonable exercise program. All diabetic patients undergoing exercise therapy should have a thorough medical history and examination.
If they are elderly or have lung disease, they should add pulmonary function test, blood pressure test, and eye fundus check if they are in condition. If they have serious cardiopulmonary dysfunction or history of bleeding in the eye fundus, they should not participate in exercise, and if blood pressure rises after exercise, bleeding in the eye fundus or myocardial ischemia, they should stop or reduce exercise.
Precautions when exercising
Before the formal exercise to do 10-15 minutes of warm-up exercises, such as stretching, leg lifting, slow walking, etc., so that muscle activity, to avoid muscle strain. After the start of the exercise should be slow to fast, the intensity of the exercise from small to large, 5-10 minutes gradually increase the amount, each exercise duration is generally in 20-30 minutes is appropriate. To choose the right shoes and socks, pay special attention to the confinement and ventilation of shoes and socks, as many diabetic patients combined with peripheral neuropathy, resulting in reduced sensation in the foot or thickening and hardening of the plantar skin, the foot is easily damaged, exercise should wear loose, soft and comfortable shoes, shoes with good ventilation, such as sports shoes, rubber shoes. You should choose a safe sports field, find a good sports partner, and avoid exercising alone.
If it is in the hot summer, wear light cotton fabric, it can absorb sweat and make the moisture evaporate, so as to maintain a normal body temperature, should also pay attention to timely hydration in sports and after sports, so as to avoid dehydration; if it is in winter, do not wear a layer of thick clothes, it is best to wear multiple layers of clothing, so as to ensure the warmth, the main thing is that in the process of exercise if you feel hot, you can properly take off one or two pieces of clothing, if Wear a thick clothes, sports off is easy to catch a cold, in addition to wear a hat and gloves to keep warm.
Older diabetics or those who have been injured during previous exercise, also pay attention to the protection of individual vulnerable parts, it is best to wear protective gear, such as knee pads, wrist guards, etc.
Do not stop suddenly at the end, you should gradually slow down the pace and do about 10 minutes of recovery activities before sitting down to rest. Must pay attention to gradually increase the amount and intensity of exercise, step by step, do not be too hasty, should be with the strengthening of the body and the body’s degree of adaptation to continuously increase the amount of exercise, to be consistent, to ensure that at least 3 times a week exercise. To prevent accidents, carry a diabetic condition card with your name, age, home address and contact number when exercising. Pay attention to changes in heart rate and self-perception, if you feel bad, stop exercising immediately and get help from others. Carry a few pieces of candy with you to replenish sugar in time in case of hypoglycemia.
Sweaty clothes should be replaced immediately after exercise to prevent catching a cold. You should replenish water in time in hot summer, but not drink too much water at one time (easy to feel fatigue and increase the burden on the stomach). Make good exercise records, and changes in blood glucose values before, after and during exercise should be monitored regularly. If there is discomfort, ask the doctor or professional nurse to adjust the exercise prescription accordingly.
In addition, diabetic patients often have hypoglycemia and foot injury in the process of exercise, which should pay attention to the following points: 1. Do not exercise vigorously in the early morning on an empty stomach, because early morning is the time of the day when the human body has the lowest blood sugar, exercise at this time, especially when the amount of exercise is prone to hypoglycemic reaction, advocate post-meal exercise. 2. Arrange the amount of exercise reasonably and do not exercise strenuously in super large quantities. 4. Carbohydrates that can be easily absorbed, such as glucose tablets, soft drinks, raisins, candies, etc., should be carried when exercising.
How to choose the type of exercise
To choose sports according to their own conditions and the surrounding environment, according to local conditions, try to choose a safe and convenient form of exercise, the following sports can be chosen. Light exercise: shopping, walking, radio exercises, taijiquan, qigong. Moderate exercise: brisk walking, jogging, cycling, up and down the stairs, aerobics. Intense exercise: fast running, rope skipping, mountain climbing, swimming, ball games.
It is necessary to choose the way of exercise in combination with the severity of my condition and whether it is accompanied by comorbidities. For people with unstable and fluctuating blood sugar, it is generally not recommended to choose exercises with long duration and high exercise volume; people with heart disease are not recommended to choose exercises with medium volume or above; people with obesity and knee disease are also not recommended to perform exercises with medium intensity or above that require lower limb weight-bearing.
How to arrange the exercise time and intensity
Diabetic patients are more suitable to exercise after meals, which is conducive to reducing postprandial hyperglycemia, after breakfast is the highest blood sugar moment of the day, so arrange the best exercise in one hour after breakfast (from the first bite), and for patients with poor blood sugar control before breakfast and after dinner, you can also choose to exercise before breakfast and after dinner time. It is most beneficial to keep exercising every day, not less than 3 times a week, and each time need to insist on 30-60 minutes. The appropriate amount of exercise is: feeling warm, slight sweating, mild muscle pain, feeling energetic the next day, desire to exercise, good appetite and sleep. Excessive exercise is characterized by heavy sweating, shortness of breath, chest tightness, lack of food and drink, and weakness and poor spirit the next day, requiring timely reduction of exercise.
The heart rate during exercise is an important indicator to determine the intensity of exercise. A more scientific method is “maximum safe exercise heart rate = 170 – age” to determine the size of your exercise. For example, if your age is 65, then your exercise intensity, that is, your heart rate when exercising should be 170-65 = 105 beats per minute. Your heart rate of about 105 beats per minute when you run and walk will have reached your exercise intensity. When the exercise is too much, the heart rate still can not return to the level before exercise 10-20 minutes after the end of exercise, feeling fatigue, panic, poor sleep, loss of appetite, etc. If the body does not have fever, no sweat, no significant change or change in pulse after exercise, and quickly return to normal within 2 minutes after the exercise stops, it indicates that the exercise is too little. Some people may have a big appetite after exercise, but exercise is never an excuse to eat and drink. The diet should still be carried out in accordance with the program developed by the doctor, and the nutrition and energy should be supplemented regularly.
People who are not suitable to participate in exercise therapy
1. Patients with type 1 diabetes and severe insulin deficiency. These people will accelerate the decomposition of liver glycogen and muscle glycogen during and after exercise, resulting in increased blood sugar and increased lipolysis, which can easily produce ketone bodies and may lead to diabetic ketoacidosis in severe cases.
2, patients with acute complications of combined diabetes, such as ketoacidosis, when accompanied by acute infection.
3.Patients with diabetic retinopathy and a tendency to bleed from the fundus of the eye. After exercise due to increased blood pressure and accelerated blood flow, can occur or aggravate the fundus hemorrhage.
4, diabetic nephropathy patients, exercise can reduce renal blood flow, urine protein and urea nitrogen content increases, aggravating the kidney condition.
5, heart and lung insufficiency, patients with hypertension and ischemic heart disease. Such people exercise when the blood pressure rises, heart ischemia aggravated, easily induced angina and myocardial infarction or lead to cerebrovascular disease, and even the risk of sudden death.