Construction Of A Motor Guidance Program For Patients With Type 2 Diabetes

ObjectiveTo investigate the status of exercises knowledge and exercises behavior of patients with type 2 diabetes mellitus(T2DM),and to know the shortage of exercises in the patient with T2DM.By searching,screening,analysis and quality evaluation of clinical practice guidelines,systematic reviews and randomized controlled trials for T2DM patients exercise,and then holding an expert meeting to modify the programme,"Exercises guidance for patients with T2DM " will be developed.Methods1.Cross-sectional survey:using the convenient sampling and self designed T2DM patient movement questionnaire to investigate the T2DM patients who were out and hospitalized in Department of endocrinology of a 3 A hospital in Chaoyang District,Beijing from February to May,2017.2.Literature research:All the clinical practice guidelines,systematic reviews and RCTs on T2DM were searched.Appraisal of Guidelines for Research and Evaluation ?(AGREE ?)and bias risk assessment tool(ROB)were used to evaluate the quality of the included guidelines and RCTs,to extract and analyzethe content of exercises effect,exercises assessment,indications and contraindications,time,mode,frequency,intensity,and so on.3.Constructing a programme:The constructing of the programme is based on T2DM patients' exercises related clinical practice guidelines,systematic reviews and RCT's comprehensive retrieval and content analysis.The final draft of "Exercises guidance for patients with T2DM " is finally formed by the convening of an expert demonstration to modify the program.Results1.Survey of exercises knowledge level and exercises behaviour of patients with T2DM:148 valid questionnaires were collected.lt was showed that T2DM patients lack of exercises knowledge,61.9%of T2DM patients had received exercise guidance from medical staff,and there are 46.3%of the T2DM patients to exercise guidance contents dissatisfied;T2DM patients daily exercises were aerobic exercise,included walking,brisk walking,running.37.8%of the T2DM patients chose a way of exercise,and 13.5%of the T2DM patients chose walking only in the past three months.36.5%of patients with T2DM did not have exercise habit.There were many shortages in T2DM patients' exercisest,such as incorrect starting time of movement and duration of movement,substandard exercise frequency,ignoring blood glucose monitoring before exercise.2.Searching guidelines,systematic reviews and RCTs on exercises of T2DM patients published in Chinese and English:According to the inclusion and exclusion criteria,5 guidelines and 56 RCTs were included respectively.AGREE ? was used to evaluate 5 guidelines,and it was showed that:average standard score of scope and purpose,participated in various fields,rigor,clarity,application type,independence were 96.1%,69.7%,67.1%,83.6%,61.9%,76.3%respectively,including 3 grade A guidelins and 2 grade B guidlines,and overall quality is better.But the quality of Chinese guidelines should be further improved.By using ROB to evaluate RCT,it was showed that each RCT mentioned "random",but the specific random methods were not described.Most RCTs outcomes were complete and there was no selective reporting outcome.Data were collected and arranged from the guidelines and RCTs about the patient's exercise effect,assessment,indications and contraindications,time,mode,frequency and intensity.Systematic reviews were not included in the construction of the programme because their conclusions were the same as the 5 guidelines.3.Developing the program "Exercises guidance for patients with T2DM":The initially constructed of T2DM patients' exercise guidance program was based on cross-sectional survey results of T2DM patients' exercises and literature research results-the guide recommendations were combined with the contents of the RCT.Based on the experts'argumentation,the final draft of "Exercises guidance for patients with T2DM" were determined.The contents of the program include:introduction,exercise effect for diabetes patients,the exercise indications and contraindication with T2DM,the exercise evaluation content in patients with type 2 diabetes mellitus before exercises,the exercises mode of T2DM,exercise intensity,exercise time,exercise frequency,exercise caution,the assessment table of patients with type 2 diabetes,a total of 10 parts.ConclusionsT2DM patients don't master exercise knowledge comprehensive,and their knowledge of sports indications and contraindications is poor.T2DM patients lack resistant exercise and regular exercises.It is suggested that strengthen exercise guidance and health education for the T2DM patients by medical staff,and then to improve the sports knowledge level of patients and promote their correct exercise behavior.On basis of 5 guidelines and 57 RCTs and the experts' argumentation,the "Exercises guidance for patients with T2DM" is scientific and precise,and can be used as a clinical exercise guidence material as well as learning materials for the patient with T2DM.It will help the patient to establish good sports behavior,and enhance the effect of exercise for them.