基于计步器的运动管理对2型糖尿病患者糖脂代谢的影响

目的：探讨以电子计步器为基础的运动管理对2型糖尿病(T2DM)患者运动血糖以及血脂的影响。方法选择2012-2015年在本院接受体检、疗养和治疗的80例T2DM患者作为研究对象，采用随机数字表法将其随机分为干预组和对照组，每组40例。对照组采取常规糖尿病管理策略，干预组在常规治疗的基础上配发电子计步器，经过2周的适应后，要求患者晚餐后进行3000~4000步/30~40 min的运动，运动频率每周不少于5 d。12周后比较两组患者的糖脂代谢指标的变化并进行统计学分析。结果干预组中有3例患者未能完成试验，与对照组比较，其余37例患者空腹血糖(7.5±0.7) mmol/L vs (7.1±0.6) mmol/L)]、空腹C肽(2.5±1.0) ng/mL vs (1.9±1.1) ng/mL]、空腹胰岛素(13.3±2.2) mU/L vs (11.1±2.6) mU/L]、糖化血红蛋白(7.5±0.7)%vs (7.0±0.8)%]、2 h血糖(10.5±2.2) mmol/L vs (7.0±0.8) mmol/L ]及胰岛素抵抗指数(3.9±2.6) vs (2.3±2.1)]均有显著改善，差异均有统计学意义(P<0.05)；干预组低密度脂蛋白胆固醇为(2.6±1.0) mmol/L，较对照组的(3.1±0.9) mmol/L明显降低，差异有统计学意义(P<0.05)。结论基于电子计步器的运动干预可以明显提高T2DM患者的运动主动性及依从性，且能够不同程度的改善糖脂代谢，值得进一步推广。

Effect of pedometer-based exercise intervention on glucose and lipid metabolism in patients with type 2 diabetes

Objective To investigate the effect of pedometer-based exercise intervention on glucose and lipid metabolism in patients with type 2 diabetes mellitus (T2DM). Methods Eighty patients with T2DM received physical examination, nursing and treatment in our hospital from 2012 to 2015 were selected as research subjects and randomly divided into the intervention group and control group, with 40 patients in each group. The control group received conven-tional diabetes management strategy. The intervention group was allotted electronic pedometer based on routine treat-ment. After two weeks of adaptation, the patients were required to perform 3000~4000 steps/30~40 minutes of exercise after dinner, and exercise frequency was not less than five days a week. Changes of glucose and lipid metabolism in two groups were compared and analyzed after 12 weeks. Results Three patients in the intervention group failed to com-plete the test. Compared with the control group, the fasting plasma glucose (7.5±0.7) mmol/L vs (7.1±0.6) mmol/L], fast-ing C-peptide (2.5±1.0) ng/mL vs (1.9±1.1) ng/mL], fasting insulin (13.3±2.2) mU/L vs (11.1±2.6) mU/L], glycated hae-moglobin (7.5±0.7)%vs (7.0±0.8)%], 2-hour post-load plasma glucose (10.5±2.2) mmol/L vs (7.0±0.8) mmol/L], and insulin resistance index (3.9±2.6) vs (2.3±2.1)] of the remaining 37 patients were significantly improved, and the differ-ences were statistically significant (P<0.05). The low-density lipoprotein cholesterol in intervention group was signifi-cantly lower than that in the control group (2.6 ± 1.0) mmol/L vs (3.1 ± 0.9) mmol/L, P<0.05]. Conclusion Pedome-ter-based exercise intervention can significantly improve exercise initiative, compliance, as well as glucose and lipid me-tabolism in T2DM patients. It is worthy of further promotion.