Indications and Contraindications of Exercise Treatment for Diabetic

Indications and Contraindications of Exercise Treatment for Diabetic

Safety means that reasonable exercise therapy improves glucose and lipid metabolism while avoiding cardiovascular events (angina pectoris attacks, sudden death, etc.), metabolic disorders, and bone, joint, and ligament injuries caused by inappropriate exercise methods or intensity.

Therefore, the indications and contraindications for exercise treatment of diabetes must be strictly controlled. Indications for exercise treatment of diabetes can be divided into absolute indications and relative indications based on the presence or absence of complications and their severity.

Absolute indications: Patients with impaired glucose tolerance and type 2 diabetes patients without significant hyperglycemia or complications.

Relative indications: Patients with mild comorbidities such as microalbuminuria, simple retinopathy without fundus hemorrhage, and diabetic peripheral neuropathy without obvious autonomic nervous system disorder can undergo exercise therapy after dietary guidance and drug control of blood sugar. ; Type 1 diabetes patients without ketoacidosis can effectively control blood sugar at a good level by performing exercise therapy on the basis of adjusting their diet and insulin dosage.

Contraindications: diabetic ketoacidosis, FPG greater than 16.7mmol/L, proliferative retinopathy, nephropathy (Cr>1.768 mmol/L), severe cardiovascular and cerebrovascular diseases (unstable angina, severe arrhythmia, transient cerebral infarction) ischemic attack) and patients with acute infection. Because patients with diabetes often have related complications such as cardiovascular disease, hypertension, severe peripheral neuropathy, severe autonomic neuropathy, proliferative prediabetic retinopathy or proliferative retinopathy, it is particularly important to ensure the safety of exercise.

For diabetics,because exercise therapy is often more strenuous than the patient's daily activities, you should first consult a doctor or a professional sports doctor to decide whether you need to perform ECG exercise stress before exercise based on your blood sugar control, physical fitness, medication, and complication screening status. Experiment to avoid inappropriate exercise-induced acute events of cardiovascular disease or aggravation of complications.

In addition, when formulating exercise prescriptions for diabetes, the patient's exercise ability and level should be taken into consideration. There should be preparatory activities before and after exercise, and cleaning activities after exercise to avoid cardiovascular and cerebrovascular accidents or muscle and bone joint injuries to ensure the safety of the exercise process. Arrange appropriate exercise time to avoid special situations such as hypoglycemia and prevent liver and kidney damage caused by excessive exercise

References

1.Chinese Guidelines of Exercise Therapy in Diabetes Mellitus