Many patients with type 2 diabetes caused by obesity when complications arise, originally because of obesity afraid to exercise they become more afraid to exercise, afraid that it will affect the disease. This is certainly not possible! Because obesity can cause a variety of metabolic diseases, some type 2 diabetes patients will be combined with coronary heart disease, hypertension, and a variety of metabolic diseases. As the saying goes, “live to ninety-nine by walking a hundred steps after meals,” along with obese patients are still recommended to do more light exercise.
Diabetes combined with coronary heart disease
Coronary heart disease is a common cardiovascular disease in diabetic patients due to myocardial dysfunction and (or) organic lesions caused by narrowing of the coronary arteries and insufficient blood supply, also known as ischemic heart disease. Although improper exercise can induce or aggravate myocardial ischemia, but diabetes combined with coronary heart disease is not an absolute contraindication to exercise, for patients with diabetes combined with coronary heart disease, appropriate regular exercise has better efficacy than simple drug therapy.
1.It is beneficial to enhance insulin sensitivity and reduce insulin resistance in diabetic patients, thus improving abnormal glucose metabolism and lowering blood sugar.
2. It is also conducive to the opening of coronary collateral circulation, improving myocardial blood supply and myocardial function, and avoiding negative effects such as venous thrombosis, skeletal muscle atrophy and low muscle strength caused by prolonged and excessive quiet bed rest.
Exercise intensity: In recent years, it is agreed at home and abroad that the trend of exercise for patients with diabetes combined with heart disease is to use low-intensity exercise, and the intensity of exercise depends on the disease and must be individualized, so patients with diabetes combined with coronary heart disease should ask their doctors to order individualized exercise intensity.
Exercise time: lower exercise intensity for long-term exercise is both safe and effective, generally 20 to 45 minutes each time, up to 1 hour, 3 to 4 times a week. The exercise process should be gradual, and according to the reflection of the exercise process, adjust the intensity and duration of exercise.
Exercise form: Patients with coronary heart disease are not suitable for intense exercise with too much intensity and speed, so choose the rhythm of the slower, can make the upper and lower limbs of the large group of muscle groups appropriate activities, such as tai chi, walking, cycling, etc.
Diabetes combined with hypertension
Hypertension is a common comorbidity of diabetic patients, the blood pressure of diabetic patients requires control below 140/80 mm Hg, blood pressure ≥ 180/120 mm Hg is uncontrolled hypertension, included in the category of exercise contraindication (at this time can not exercise); when the blood pressure is controlled at ≤ 160/100 mm Hg, it is recommended that relaxation training exercise under the guidance of professionals.
Exercise intensity: should be low to moderate exercise intensity, moderate intensity aerobic exercise for 40% to 70% of the maximum heart rate (the maximum heart rate is calculated as 220 – age).
Exercise duration: Exercise greater than 4 days in a week, it is best to exercise every day for not less than 30 minutes, or 30 minutes of exercise time accumulated in a day.
Exercise form: Patients with hypertension should avoid doing breath-holding action or high-intensity exercise to prevent the danger of excessive increase in blood pressure, so more relaxation training (such as tai chi, yoga, etc.) and aerobic exercise (such as walking, power cycling, swimming).
Diabetes combined with cerebrovascular disease
Many diabetic patients with combined cerebrovascular disease will have limb hemiplegia and other conditions after a stroke, resulting in limited mobility and even more restricted movement. Diabetic patients with limb hemiplegia should undergo routine limb rehabilitation training to improve healing.
Exercise prerequisites: Exercise under the guidance of a rehabilitation medicine professional.
Exercise intensity: for low intensity exercise.
Exercise form: Start with routine limb rehabilitation training for stroke, such as daily living movements. When the patient has recovered physical fitness and exercise endurance, then adjust according to the exercise prescription for diabetes according to the blood glucose and insulin situation. The intensity and form of exercise should be carried out under the guidance of a professional physician.
Diabetes combined with cerebrovascular disease attack, the light limb hemiplegia affects normal life, or serious death. Therefore, we must do a good job of prevention of cerebrovascular disease, such as regular daily physical exercise, once the cerebrovascular disease attack caused serious consequences, regret too late.
Diabetes combined with peripheral artery disease
Lower extremity atherosclerosis occlusive disease is more likely to occur in elderly people over 60 years old, while diabetic patients have an earlier onset, and more men than women. The lesions mostly occur at the branches of blood vessels, causing luminal narrowing or occlusion, resulting in insufficient blood supply to the distal end of the lesion, which mainly manifests as intermittent claudication.
There are two manifestations of intermittent claudication, and the diagnosis can be confirmed if you have one of the following conditions.
1. limp due to muscle spasm, tension, pain and weakness on the affected side after walking a certain distance, which is rapidly relieved after rest and then recurs after walking again.
2, rest pain, especially night pain, patients often sit with their legs, unable to sleep, relieved when the affected limb drops or is cold. There may also be cold feet, abnormal sensation, pale or bruised skin, subcutaneous fat atrophy and other manifestations, and even dry gangrene or ulcers on the lower legs and feet.
Some diabetic patients with intermittent claudication become afraid to exercise, and others do not know how to do so.
Exercise forms: Since patients have lesions in the lower limbs, they are not suitable for lower limb exercise, so patients can perform exercise exercises for the upper limbs and trunk muscles, such as aerobic exercises like hand crank. Plate training and lower limb resistance training can also be performed under the guidance of a professional physician to increase the patient’s motor function.
Exercise time: once a day.
Exercise intensity: moderate intensity.