Effect Of Exercise Therapy Combined With Nutritional Intervention In The Treatment Of Type 2 Diabetes

Background: Type 2 diabetes mellitus(T2DM)is a group of chronic diseases characterized by disorders of blood glucose metabolism,and is also a typical lifestyle disease.Foreign studies have found that lacking of exercise is an independent risk factor for type 2 diabetes mellitus.The symptoms of fatigue,muscle atrophy,decreased muscle strength and increased fracture risk during the development of diabetes are closely related to the long-term lack of exercise in diabetic patients.On the contrary,the long-term regular and scientific exercise can effectively improve the blood sugar and weight of type 2 diabetes patients;At the same time,the research data found that exercise also plays an irreplaceable role in improving the uptake and utilization of insulin in tissues and organs of T2 DM patients,improving blood lipid metabolism,enhancing muscle strength,improving body adaptability,and slowing down the occurrence of long-term complications.However,there are still some diabetics who fail to participate in sports effectively and fail to supplement nutrients in time after exercise,thus resulting in Osteoporosis,fracture,exercise fatigue,hypoglycemia,dehydration,electrolyte disorder and other adverse events.The synthetic phase(30min after exercise)is the most critical period in the nutrient timing system.Protein supplementation during this period can transform muscle protein from a decomposed state to a synthesized state,which is beneficial to repair damaged muscles.30 minutes after exercise,the blood in the muscle tissue is in a highly filled and fast-flowing state,at this time,supplementing with sufficient amino acids can enable the muscle tissue to quickly synthesize muscle protein to the greatest extent and repair damaged muscles.On the contrary,with the extension of time,the muscle blood filling and flow rate gradually decrease,at this time,even if sufficient amino acids are ingested,the blood system cannot quickly bring it into the muscle tissue,which greatly reduces the nutritional supplement efficacy.Whey protein is a kind of high-quality protein extracted from milk,which can delay the occurrence of fatigue,enhance the synthesis of muscle protein,increase the secretion of insulin and lower blood sugar.Compared with other nutritional supplements,whey protein can be absorbed more quickly in the intestine.It is the supplement that best meets the principle of timeliness of sports nutrition.Meanwhile,whey protein is the first recommended nutritional treatment in the consensus of sarcopenia treatment experts.Therefore,we give whey protein nutrition supplements after exercise for patients with type 2 diabetes,aiming to reduce blood sugar fluctuations,better control blood sugar and weight,relieve sports fatigue,strengthen muscle strength,improve exercise effects and improve quality of life,etc.Objective: To explore the effect of exercise therapy combined with nutritional intervention on patients with type 2 diabetes.Methods: A total of 26 patients with type 2 diabetes treated in The Affiliated Rehabilitation Hospital of CQMU from February 2019 toDecember 2019 were randomly divided into exercise therapy + nutrition intervention group(n = 12)and exercise therapy group(n = 14),of which the former was the research group and the latter the control group.The control group only performed exercise therapy,that is,resistance level 2-5should be conducted once a day at 1h after meals,moderate-strength(RPE12-13 grade)limb linkage training,30 minutes each time,for 4 weeks of continuous training;the study group was given nutritional supplements half an hour after the end of exercise therapy.The two groups of subjects carried out this study on the basis of the original personalized drug treatment,and all were given basic dietary nutrition guidance for diabetic patients,and the nutritional baseline was based on daily physical energy intake(unit: Kcal).The intervention period was 4 weeks,respectively in 2weeks,4 weeks follow-up blood routine,liver function,renal function,fasting venous blood sugar,finger blood glucose,body weight,BMI,skinfold thickness,abdominal circumference,muscle circumference,muscle strength,daily life activities ability(ADL score),and then,the differences of the above follow-up indexes between the subjects in the study group and the control group were compared and analyzed after intervention.Results: Baseline comparison: There was no significant difference in fasting venous blood glucose,blood glucose fluctuation,nutritional status,liver and kidney function,body weight,BMI,skinfold thickness,abdominal circumference,muscle circumference,muscle strength,and ADL scores in the two groups of subjects before intervention(P> 0.05),that is,the baseline conditions are basically the same.Results after the intervention: After 4weeks of intervention,the weight,BMI,skinfold thickness,ADL score,fasting venous blood glucose,and muscle strength of the two groups ofsubjects were improved to different degrees than before the intervention.After intervention,the weight,BMI,skinfold thickness,abdominal circumference,muscle circumference,muscle strength,ADL score,fasting venous blood glucose,and blood glucose fluctuations of the study group were better improved than the control group,and the difference was statistically significant(P <0.05),especially the difference between blood glucose fluctuation and lower limb muscle strength(P <0.01).Conclusion: Compared with exercise therapy alone,exercise therapy combined with nutritional intervention for patients with type 2 diabetes can effectively reduce the patient’s weight and blood sugar level,reduce blood sugar fluctuations,and at the same time can effectively increase the patient’s muscle mass,enhance muscle strength,improve the exercise ability and daily living ability,and further improve the patient’s quality of life.