Different Exercise Prescriptions Regimens on Diabetes Treatment

Different Exercise Prescriptions Regimens on Diabetes Treatment

1.Excercise Type 

Based on current research findings, both aerobic exercise and resistance training are highly recommended for individuals with diabetes. Optimal exercise programs for type 2 diabetes patients typically prioritize aerobic activities. Combining aerobic exercise with resistance training yields superior glycemic control, particularly among individuals with poor glycemic management. Integrating resistance training into exercise routines results in enhanced metabolic improvements. While aerobic exercise offers benefits for overall metabolism, its impact on glucose tolerance and long-term glycemic control may be less pronounced. Nonetheless, a comprehensive exercise regimen comprising regular aerobic exercise and structured resistance training engages more muscle groups, fostering better participation in physical activity.

For patients with diabetes, aerobic activities should involve moderate to low-intensity rhythmic exercises such as walking, jogging, cycling, swimming, and full-body aerobic routines like Tai Chi. Additionally, recreational activities such as table tennis, bowling, and badminton are suitable options. Some studies suggest exercising 90 minutes post-meal yields the most significant immediate hypoglycemic effect in type 2 diabetes patients. Notably, regardless of the exercise modality, as long as energy expenditure remains consistent, the impact on blood sugar control appears similar.

Obese patients with diabetes can engage in the aforementioned activities, with exercise intensity adjusted to low levels and durations extended as necessary, tailored to individual characteristics and preferences.

2.Exercise Intensity

Exercise intensity plays a crucial role in managing type 2 diabetes and obese diabetes, with different intensities yielding varied effects. Lower-intensity exercises primarily utilize fat for energy metabolism, whereas moderate-intensity exercises significantly reduce blood and urine sugar levels. To ensure safety and effectiveness, exercise intensity must be maintained within established parameters. Exceeding 80% VO2max poses risks, while exercising below 50% VO2max is suitable for elderly and cardiac patients. Middle-aged and elderly diabetic patients often benefit from exercising at 50% to 60% VO2max to accommodate various complications.

Research indicates that prolonged aerobic exercise reduces liver damage and improves glucose metabolism in diabetic rats. Similarly, high-intensity resistance training leads to enhanced blood sugar control and reduced HbA1c levels in older individuals. Resistance training offers comparable or superior benefits to aerobic exercise in improving glucose and lipid metabolism.

3. Exercise Duration

Each exercise session should include 5 to 10 minutes of warm-up and cool-down activities, with the effective heart rate maintained for 10 to 30 minutes during exercise. Adjustments in exercise duration are necessary based on intensity levels, with shorter durations for higher intensities and vice versa. Patients with mild symptoms and good physical fitness may opt for shorter, high-intensity sessions, while older or obese individuals may benefit from longer, low-intensity workouts.

Starting exercise 30 minutes before peak blood sugar times and maintaining an intensity of 3.3 METs for 40 minutes can significantly reduce postprandial blood sugar spikes in type 2 diabetes patients. Exercise after meals contributes to lowering the area under the blood sugar curve, particularly in patients with a longer diabetes history and higher BMI.

4. Exercise Frequency

Structured lifestyle modifications, including calorie reduction, daily aerobic exercise, and weight loss, are integral to preventing and managing type 2 diabetes. Consistent exercise, ideally performed 3 to 7 days per week, helps maintain insulin sensitivity and accumulates beneficial effects. Prolonged exercise intervals exceeding three days may diminish insulin sensitivity and reduce the cumulative benefits of exercise. Tailoring exercise frequency to individual capabilities ensures adherence and sustainability.

5. Exercise Precautions

Exercise intensity should be moderated to avoid excessive stress responses and hormonal imbalances that can exacerbate blood sugar fluctuations or induce diabetic ketoacidosis. Patients experiencing significant blood sugar fluctuations, fatigue, or difficulty in recovery during exercise should adjust intensity or cease activity promptly. Additionally, diabetic patients should consider dietary adjustments and medication management to prevent hypoglycemia during intense or prolonged exercise sessions.

By adhering to these exercise guidelines, individuals with diabetes can effectively manage their condition and improve overall health outcomes.

References

1.Chinese Guidelines of Exercise Therapy in Diabetes Mellitus