Life is about exercise. Many people with diabetes become afraid to exercise when complications arise, fearing that exercise will affect their condition. So when a diabetic patient develops complications, how to exercise?
Diabetic world diabetes combined with coronary heart disease coronary heart disease is the myocardial dysfunction and/or organic lesion caused by the narrowing of coronary arteries and insufficient blood supply, also known as ischemic heart disease, is a common cardiovascular disease in diabetic patients. It is a common cardiovascular disease in patients with diabetes mellitus. The main manifestation is a crushing pain in the precordial region, which may extend to the neck, jaw, arm, back and stomach. The attack may be accompanied by dizziness, shortness of breath, sweating, shivering, nausea and fainting. Severe cases may result in death due to heart failure.
Although improper exercise can induce or aggravate myocardial ischemia, diabetes combined with coronary artery disease is not an absolute contraindication to exercise. For patients with diabetes combined with coronary artery disease, proper and regular exercise has better efficacy than drug therapy alone, which is conducive to enhancing insulin sensitivity and reducing insulin resistance in diabetic patients, thus improving abnormal glucose metabolism and lowering blood glucose; at the same time, it is conducive to promoting the opening of coronary collateral circulation and Improving myocardial blood supply and myocardial function, avoiding negative effects such as venous thrombosis, skeletal muscle atrophy and low muscle strength caused by long-term 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 too fast speed, so choose the rhythm is slower, can make the upper and lower limbs of large groups of muscle groups appropriate activities, such as tai chi, walking, cycling, etc.
Diabetes combined with hypertension hypertension is a common comorbidity in diabetic patients, the blood pressure of diabetic patients requires control of 140/80 mm Hg or less, 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 to relaxation training under the guidance of professionals Exercise.
Exercise intensity: should be low to moderate exercise intensity, moderate intensity aerobic exercise for 40% to 70% of the maximum heart rate (maximum heart rate is calculated as 220 – age).
Exercise duration: Exercise more than 4 days in a week, and it is best to exercise every day for at least 30 minutes, or up to 30 minutes cumulatively throughout the 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 limited 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 arterial disease lower limb atherosclerosis occlusive disease is more likely to occur in the elderly over 60 years of age, diabetes patients are earlier onset, 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 as long as you have one of them: first, muscle spasm, tension, pain and weakness on the affected side after walking a certain distance, resulting in claudication, which is rapidly relieved after rest and recurs after walking again; second, pain at rest, especially at night, and the patient often sits with his leg in his arms and cannot sleep, which is relieved when the affected limb droops or is cold. There can also be cold feet, abnormal sensation, pale or bruised skin, subcutaneous fat atrophy and other manifestations, and even dry gangrene or ulceration of the lower leg and foot can occur. Some diabetic patients become afraid to exercise after intermittent claudication, and some others do not know how to do it.
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.
Autonomic neuropathy Autonomic neuropathy increases the risk of motor injury or negative events by reducing the cardiovascular system’s response to exercise, postural hypotension; impairs the thermoregulatory system and night vision; and unpredictable gastroparesis can lead to impaired carbohydrate absorption and hypoglycemia. Therefore, exercise is contraindicated in diabetic patients with severe autonomic neuropathy involving the cardiovascular system unless there is good safety because of the risk of acute cardiovascular events during exercise.
Peripheral neuropathy manifests as neuropathic pain and loss of sensation, increasing the risk of foot injury and ulceration; limb paralysis can occur when the motor nerve is involved. However, studies have shown that exercise therapy can prevent the development of peripheral neuropathy and restore nerve conduction velocity, significantly improving diabetic peripheral neuropathy.
With acute foot ulcers: non-weight-bearing upper extremity exercise training, such as aerobic exercises like hand cycling.
Without acute foot ulcers: perform moderate intensity weight-bearing exercises (such as brisk walking, jogging, weight lifting, etc.). When weight-bearing exercises are performed, the pressure applied to the bones increases the number of bone cells, which helps increase bone density.
Diabetes combined with chronic obstructive pulmonary disease (COPD) Winter is a period of high incidence of respiratory diseases, and diabetic patients are prone to combined COPD, which mainly manifests as breathing difficulties, and patients also have reduced exercise endurance due to peripheral muscle fatigue. Therefore, patients with diabetes mellitus combined with COPD should exercise to prevent the decline of exercise endurance.
Exercise intensity: moderate intensity.
Exercise duration: at least 20-30 minutes of exercise each time, 2-5 times a week for 8-12 weeks of exercise training.
Exercise form: aerobic exercise including brisk walking, jogging, going up and down stairs, etc. Resistance training includes various kinds of apparatus-holding gymnastics. Patients can use intermittent exercise, alternating between exercise and rest to reduce dyspnea during exercise, and should be accompanied by respiratory gymnastics to reduce shortness of breath symptoms.