目的 初步探讨短期运动干预方案对2型糖尿病(type 2 diabetes mellitus,T2DM)住院患者外科术前血糖的影响。方法 选择2017-08至2018-06解放军总医院第三医学中心收治的合并T2DM拟实施手术的住院患者45例,采用随机数字表法分为中强度间歇运动组、低强度持续运动组及对照组,每组15例。对运动组患者进行为期3~5 d不同强度和方式的运动干预;相同条件下对照组患者仅实施术前基础护理和常规宣教。随即通过生化检查和动态血糖监测系统(CGMS)评估干预前后3组患者空腹血糖(FPG)、餐后血糖(PPG)、空腹胰岛素(Fins)、稳态模型胰岛素抵抗指数(HOMA-IR),以及稳态模型胰岛素敏感指数自然对数(lnIS)以观察患者短期内血糖管控情况。结果 (1)运动组患者经过3 d运动干预后,中强度运动组血糖整体达标率高于对照组,且差异有统计学意义(P＜0.05);运动组的血糖指标中除FPG外,其余各项均低于对照组(P＜0.05);其中中强度间歇运动较低强度持续运动在患者PPG改善方面效果更为显著(P＜0.05)。(2)运动干预方案实施5 d后,低强度持续运动组患者血糖指标中PPG指标低于对照组,差异有统计学意义(P＜0.05);中强度间歇运动组患者除FPG外,其余各项血糖指标较对照组均发生显著变化,差异有统计学意义(P＜0.05)。结论 短期运动干预方案对2型糖尿病术前血糖调控有积极作用。
Abstract
Objective To tentatively investigate the effect of short-term exercise interventions on preoperative blood glucose in patients with type 2 diabetes mellitus (T2DM).Methods Forty-five patients with T2DM scheduled for surgery were randomly divided into the moderate-intensity intermittent exercise group, low-intensity continuous exercise group and control group, with fifteen cases in each. The two exercise groups were subjected to 3-5 days of exercise interventions of different intensities and in different modes. Under the same conditions, the control group received nothing more than preoperative basic care and routine education. In order to observe the effect of short-term glycemic control,the biochemical examination and the 24-hour continuous glucose monitoring system (CGMS) were used to evaluate the levels of FPG, PPG, Fins, HOMA-IR and lnIS of each subject before and after the intervention.Results (1) After three days of exercise intervention, the overall glycemic compliance rate of the moderate-intensity exercise group was higher than that of the control group (P<0.05). Except for FPG, all the other glycemic indexes were lower than those of the control group (P<0.05). The effect of exercise on PPG improvement in patients of the moderate intermittent exercise group was even more significant than in the low-intensity continuous exercise group (P<0.05). (2) Five days after the exercise intervention program, the levels of PPG were lower in the low-intensity continuous exercise group than that in the control group (P<0.05). With the exception of FPG, all the other glycemic indexes were more significantly improved in the moderate intermittent exercise group than that in the control group(P<0.05).Conclusion The short-term exercise intervention program has a positive effect on preoperative glycemic control in T2DM inpatients.
关键词
运动干预 /
2型糖尿病 /
围术期 /
血糖管理
Key words
exercise intervention /
type 2 diabetes mellitus /
perioperative period /
glycemic management
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基金
中国研究型医院学会护理分会2017年临床护理研究课题立项及创新发明孵化基金项目(201720-6);武警部队高层次人才培养项目(2013-GCCRC-04)
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