糖尿病治疗中运动干预的相关性研究

对30例中年2型糖尿病患者在饮食和口服降糖药物及注射胰岛素治疗的基础上采用运动疗法，具体方法：3次／天。步行走、治疗前后检查各项相关指标变化。结果运动两周后30例患者的血糖，体重指数、甘油三脂、总胆固醇。明显下降。结论：有效的运动干预，是治疗糖尿病的一种重要措施。     

糖尿病治疗中运动干预的相关性研究

对30例中年2型糖尿病患者在饮食和口服降糖药物及注射胰岛素治疗的基础上采用运动疗法,具体方法3次/天,步行走、治疗前后检查各项相关指标变化.结果运动两周后30例患者的血糖,体重指数、甘油三脂、总胆固醇,明显下降.结论有效的运动干预,是治疗糖尿病的一种重要措施.     

药物治疗联合饮食、运动治疗对2型糖尿病患者血糖水平的影响

目的分析药物治疗联合饮食、运动治疗对2型糖尿病患者血糖水平的影响。方法将2015年1月—2016年12月收治的46例2型糖尿病患者作为研究对象并根据随机数字表法分组,分别23例。对照组采用单纯药物治疗,综合疗法组采用药物治疗联合饮食、运动治疗。比较两组2型糖尿病治疗总有效率;血糖水平达到正常范围时间;干预前后患者血糖水平、生活质量水平。结果综合疗法组2型糖尿病治疗总有效率高于对照组(P0.05);综合疗法组血糖水平达到正常范围时间短于对照组(P0.05);干预前两组血糖水平、生活质量水平相近(P0.05);干预后综合疗法组血糖水平、生活质量水平优于对照组(P0.05)。结论药物治疗联合饮食、运动治疗对2型糖尿病患者血糖水平具有降低作用,可促使血糖达标,改善患者预后和生活质量,值得推广应用。     

运动疗法对2型糖尿病患者的观察

目的 2型糖尿病患者进行有规律的中等强度的运动疗法,观察运动前后血糖、胰岛素水平及其曲线下面积、血脂、体重指数(BMI)、微量尿白蛋白等项的变化.方法 28例患者平均年龄59.0±7.6岁,在饮食和口服降糖药物治疗的同时,每日坚持1～1.5小时保持中等负荷强度的运动疗法,历时12个月,观察运动前后上述各项指标的变化,并随机与40例、平均年龄59.5±7.3岁,以饮食和口服降糖药物治疗为主的2型糖尿病患者作对照.结果运动组的血糖及其曲线下面积、HbAlc、肥胖型患者的BMI均有明显降低(P＜0.01),均明显优于对照组(P＜0.01).空腹及餐后2、3小时血浆胰岛素水平亦下降(P＜0.05).运动疗法对微量尿白蛋白的排出无影响(P＞0.05).结论运动疗法能明显降低2型糖尿病患者的血糖和肥胖者的体重指数,改善血脂代谢,降低胰岛素抵抗,恢复胰岛素的敏感性,其作用是单纯药物和饮食疗法不能代替的.     

康复运动疗法对老年2型糖尿病患者的干预作用

目的探讨康复运动疗法对老年2型糖尿病(T2DM)患者的干预作用。方法 58例老年T2DM患者随机分为干预组和对照组各29例,经6个月运动疗法干预后,比较血糖控制情况和运动疗法干预对血糖和血脂的影响。结果干预后,干预组空腹血糖(FPG)、餐后2 h血糖、糖化血红蛋白水平均显著低于对照组(均P<0.01);干预组FPG、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)水平均显著低于干预前(P<0.01)。结论康复运动疗法可以有效控制和降低血糖、血脂,干预效果明显。     

胰岛素泵联合饮食运动干预治疗妊娠糖尿病的临床研究

目的探讨联合胰岛素泵及饮食运动干预治疗妊娠糖尿病的应用效果。方法随机将100例妊娠糖尿病患者分为两组,每组50例。以在饮食运动疗法的基础上应用常规胰岛素治疗者为对照组,以在饮食运动疗法的基础上应用胰岛素泵治疗者为观察组。对比两组临床治疗效果。结果两组治疗前空腹血糖(FBG)及餐后2h血糖(2hFBG)比较差异无统计学意义(P0.05),而在接受治疗1周后,观察组明显低于对照组(P0.05)。同时观察组FBG达标率及2hFBG达标率明显高于对照组(P0.05)。结论联合胰岛素泵及饮食运动疗法在妊娠糖尿病患者的治疗中具有着更为理想的应用效果。     

运动疗法对于2型糖尿病治疗的应用效果刍议

目的针对运动疗法对2型糖尿病治疗中的应用效果进行分析,为临床治疗提供实例参考。方法随机选取该院2014年2月—2015年10月期间的58例糖尿病患者,其中29例设为组一,采用普通的药物治疗方法;另外29例设为组二,在普通治疗方法基础上采用运动治疗方法。在进行一段时间治疗后,运用对照法,对比两组患者的血糖维持水平以及血糖自控能力,并进行效果分析。结果在患者血糖自控能力,运动控糖常识,患者降糖积极性等方面,组二优于组一,差异有统计学意义(P0.05);组二患者血糖维持水平优于组一,差异有统计学意义(P0.05)。结论通过运动疗法对2型糖尿病患者进行指导治疗,有利于提高2型糖尿病患者对运动降糖机理的掌握程度,同时更有利于患者血糖水平的稳定,提高患者生命质量,值得临床广泛应用。     

评价运动结合心理疗法对2型糖尿病患者血糖水平的影响

目的 研讨运动结合心理疗法对2型糖尿病患者血糖水平的影响。方法 选取联勤保障部队第910医院2021年6月—2022年7月收治的74例2型糖尿病患者为研究对象,按照随机数表法分为对照组（n=37）和观察组（n=37）,两组患者均进行常规药物治疗,在此基础上对照组增加心理疗法,观察组在对照组基础上结合运动疗法,对比两组患者血糖、血脂指标及不良反应。结果 治疗后,两组患者的血糖指标均优于治疗前,且观察组优于对照组,差异有统计学意义（P<0.05）。治疗后,观察组的各项血脂指标明显优于对照组,差异有统计学意义（P<0.05）。两组患者的不良反应发生情况比较,差异无统计学意义（P>0.05）。结论 2型糖尿病患者实施运动疗法及心理疗法,可改善患者的血糖及血脂,且治疗安全性高。     

1型糖尿病合并妊娠75例临床观察

目的探讨1型糖尿病合并妊娠75例临床观察。方法回顾性分析2013年10月—2014年10月期间在该院内分泌科治疗的75例1型糖尿病合并妊娠患者的临床资料,均采用胰岛素治疗辅助饮食运动疗法,观察治疗后血糖水平、孕妇及新生儿结局。结果治疗后所有患者空腹血糖、餐后2 h血糖、糖化血红蛋白较治疗前明显改善,差异有统计学意义(P0.05);所有患者均顺利分娩,顺产42例,剖腹产33例,无产妇及新生儿死亡病例。结论全面系统的治疗能有效控制1型糖尿病合并妊娠患者的血糖水平,减少并发症,保证胎儿的顺利分娩,具有积极的临床意义。     

中医养生运动对社区2型糖尿病病人影响的研究

目的研究中医养生运动对社区2型糖尿病病人的影响。方法该文采用回顾分析的方法,选取2013年1月—2014年1月社区2型糖尿病病人60例,所有患者均给予降糖治疗,在降糖治疗的基础上配合太极拳运动,测量运动前和运动6个月后患者的餐后2 h血糖、血压以及体重。结果运动6个月后所有患者的餐后2小时血糖和血压均显著好转,与运动前比较差异有统计学意义(P<0.05);与运动前比较体重差异无统计学意义(P>0.05)。结论医养生运动可以稳定2型糖尿病病人的血糖和血压。     

Multivariable analysis of heart rate recovery after cycle ergometry in heart failure: exercise in heart failure

Purpose

The purpose of this study was to investigate the association between impairment in heart rate recovery (HR_rec) after cycle ergometry and prognostic markers in patients with heart failure (HF) compared with healthy controls.

Methods

Fifty patients with chronic HF (systolic HF, N = 30; diastolic HF, N = 20; mean age = 62 ± 12 years) and 50 healthy controls (N = 50; mean age = 66 ± 13 years) underwent 2-dimensional and M-mode echocardiography followed by cardiopulmonary exercise testing. Independent predictors of HR_rec at 1 and 2 minutes after exercise were analyzed by univariable and multivariable regression analyses, and receiver operating characteristics were performed to obtain area under the curve.

Results

In HF, left ventricular end-diastolic diameter (millimeters), left ventricular ejection fraction (%), N-terminal pro-brain natriuretic peptide (picograms/milliliter), peak oxygen uptake (VO₂peak [milliliters/kilogram/min]), and peak heart rate (HR_peak) showed a significant association with HR_rec (beats/min) in univariate regression analyses (P < .001), but only VO₂peak remained independently predictive of both HR_rec1 (P = .034) and HR_rec2 (P = .008) in the multivariable regression analyses. In controls, VO₂peak (P = .035) and HR_peak (P = .032) were significantly associated with HR_rec2 in univariate analyses only. Optimal cutoff values for discriminating HF versus non-HF based on HR_rec were 17.5 beats/min (sensitivity 92%; specificity 74%) for HR_rec1 and 31.5 beats/min (sensitivity 94%; specificity 86%) for HR_rec2. Optimal cutoff values for discriminating systolic HF versus diastolic HF were 12.5 beats/min (sensitivity 78%; specificity 80%) for HR_rec1 and 24.5 beats/min (sensitivity 82%; specificity 90%) for HR_rec2.

Conclusion

Impairment in after exercise HR_rec is significantly and independently associated with VO2peak in HF and thus might constitute a useful tool for assessing the degree of functional status during exercise rehabilitation.     

Left ventricular end‐diastolic volume predicts exercise capacity in patients with a normal ejection fraction

Background

Exercise capacity is a powerful predictor of all‐cause mortality. The duration of exercise with treadmill stress testing is an important prognostic marker in both healthy subjects and patients with cardiovascular disease. Left ventricular (LV) structure is known to adapt to sustained changes in level of physical activity.

Hypothesis

Poor exercise capacity in patients with a preserved LV ejection fraction (LVEF) should be reflected in smaller LV dimensions, and a normal exercise capacity should be associated with larger LV dimensions, irrespective of comorbidities.

Methods

This hypothesis was first tested in a cross‐sectional analysis of 201 patients with normal chamber dimensions and preserved LVEF who underwent a clinically indicated treadmill stress echocardiogram using the Bruce protocol (derivation cohort). The best LV dimensional predictor of exercise capacity was then tested in 1285 patients who had a Bruce‐protocol treadmill exercise stress test and a separate transthoracic echocardiogram (validation cohort).

Results

In the derivation cohort, there was a strong positive relationship between exercise duration and LV end‐diastolic volume deciles (r ² = 0.85; P < 0.001). Regression analyses of several LV dimensional parameters revealed that the body surface area–based LV end‐diastolic volume index was best suited to predict exercise capacity (P < 0.0001). In a large validation cohort, LV end‐diastolic volume was confirmed to predict exercise capacity (P < 0.0001).

Conclusions

Among patients referred for outpatient stress echocardiography who have a preserved LVEF and no evidence of myocardial ischemia, we found a strong positive association between LV volume and exercise capacity.     

Physical activity and sarcopenia

Physical activity can be a valuable countermeasure to sarcopenia in its treatment and prevention. In considering physical training strategies for sarcopenic subjects, it is critical to consider personal and environmental obstacles to access opportunities for physical activity for any patient with chronic disease. This article presents an overview of current knowledge of the effects of physical training on muscle function and the physical activity recommended for sarcopenic patients. So that this countermeasure strategy can be applied in practice, the authors propose a standardized protocol for prescribing physical activity in chronic diseases such as sarcopenia.     

Effect of exercise training in patients with an implantable cardioverter defibrillator.

AIMS: Little research exists on exercise performance and training in patients with an implemented cardioverter defibrillator (ICD) and only in a limited number of patients. This study aims to investigate the effect of exercise training in ICD patients in comparison to the effects in other cardiac patients without an ICD. METHODS AND RESULTS: 92 ICD patients were compared with a control group of 473 patients. A maximal cycle-spiroergometric test was performed until exhaustion before and after an ambulatory exercise training programme. Exercise training was offered 3 times a week for 3 months. The cut-off heart rate was set at (ICD detection rate -20 beats/min). At baseline, the ICD patients had a lower peak oxygen uptake (VO(2)) compared to the control group. Training effects were smaller for peak VO(2) (mL/min/kg) and oxygen pulse in the ICD group (18 vs. 27%, p = 0.006 and 11 vs. 17%, p = 0.016, respectively). Several appropriate shocks were delivered during (n = 5), and in between (n = 7), testing or training and one inappropriate shock during training. CONCLUSIONS: ICD patients can safely participate in an exercise training programme with favorable results. A randomised control study with evaluation of the physical and the psychosocial effects is warranted.     

Exercise dependent complete left bundle branch block.

Eleven patients with an exercise dependent complete left bundle branch block (CLBBB) were followed-up over a period of 2-13 years (mean 6.5 +/- 3.8). Their ages ranged from 19 to 62 years (mean 48). Four patients complained of chest pain on effort and one of palpitations. All patients underwent a clinical examination, 12 lead ECG, routine blood tests, chest X-ray, a multistage exercise test, echo Doppler, radionuclide ventriculography with TC99 and 48-h Holter monitoring. Ten were submitted to a coronary angiography with left ventriculography. The ECG at rest displayed a normal ECG in seven patients and an incomplete left bundle branch block (ILBBB) in four patients. The onset heart rate (HR) of CLBBB ranged from 95-146 beats.min-1 (mean 123) and the offset HR75-135 (mean 102 beats.min-1). Coronary angiography showed three-vessel disease in two patients and an obstruction of the left anterior descending coronary artery (LAD) in the third. In the other seven patients all the investigations (including coronary angiography) were normal. During the follow-up period the HR at onset of CLBBB decreased from 145 beats.min-1 to 100 beats.min-1 in four patients but no coronary artery disease (CAD) could be proven at coronary angiography. In our series chest pain did not always signify the presence of CAD. We conclude, that in patients with exercise-dependent CLBBB the prognosis is good if no underlying heart disease can be detected. It appears from our limited experience that an exercise-dependent CLBBB at heart rate below 125 beats.min-1 does not by itself constitute a sign of CAD.