The Effects Of Different Types Of Exercise On Metabolic Control And Complications In Chinese Diabetic Patients

Objective:To investigate the current status of exercise in diabetic patients, and to explore the impact of different types of exercise on their metabolic control, adverse events and diabetes-related complications.Methods:A total of 7131 patients with diabetes were recruited from 41 representative centers across China for this survey, from June to August of 2014. The questionnaire accessed data concerning types of exercise, exercise intensity, duration and frequency, metabolic parameters, diabetes complications and adverse events. Patients were divided into three groups according to their exercise type:aerobic exercise only (5551), resistance exercise only (20) and combined (453). Analysis of variance and Chi-square test were used to test the differences of continuous and categorical variables, respectively, among the three groups, and further analysis using regression correlation were performed to access the association between different types of exercise, metabolic control and diabetes complications.Results:1.A total of 7095 participants, meeting the inclusion criteria, were considered for the analysis and 6024 of them did regular exercise. The most common exercise was walking (4096 cases), while only 473 patients choose resistance exercise.2.Patients who reported doing exercise had a better fasting blood glucose,2h postprandial blood glucose, body mass index and systolic blood pressure. In addition, the number of complications and comorbidities were also lower than those who did not exercise.3.There were no significant differences in metabolic control and complications among the three groups(aerobic exercise only, resistance exercise only, aerobic-resistance exercise combination, P>0.05). After adjustments by linear regression analysis, patients who participate in aerobic-resistance exercise combination controlled fasting blood glucose,2h postprandial blood glucose, comorbidities and complications better than patients participating in aerobic exercise only (β= 0.348,0.781、0.204, P<0.05). Compared to resistance exercise only, aerobic-resistance exercise combined group showed better fasting plasma glucose control (β=-0.504. P<0.05).4.After adjustments by linear regression analysis, patients enrolled in fast walking had a better control of 2h postprandial glucose compared with brisk walking and Square Dance. (β=-1.63、0.724, P<0.05). Only patients who participate in tai chi had better body mass index than those that brisk walk (β=-0.504, P<0.05).5.8.69% of patients had a low blood sugar reaction during exercise and 2.66% of patients had other exercise induced adverse reactions, but only 6.60% of the patients had blood glucose monitoring during exercise.Conclusions:1. Most patients choose aerobic exercise, especially walking. Only a small number of patients participate in resistance exercise.2. Patients participating in exercise have better control of their blood sugar, blood lipids, blood pressure and body mass index. Furthermore, the prevalence of diabetes-related complications is also lower among them.3. Patients that participate in aerobic-resistance exercise control their blood glucose better than patients with separate aerobics or resistance exercise and have less diabetes complications.4. The correlation between different types of exercise, metabolic control and complications in patients with diabetes are not clear.5. The incidence of exercise-related adverse reactions is noticeably high, which reflects the need to strengthen diabetes education.