Diabities Mellitus
Posted on June 28th, 2009 in Diabities, Fitness Plus, Health News, Health Tips
The 10 points are noteworthy about this scientific statement:
1. Increasing prevalence of overweight and obesity has led to an unprecedented epidemic of type 2 diabetes (T2DM) and is likely to be followed by an epidemic of patients with complications of T2DM. The economic cost of T2DM has been estimated at $ 172 million in 2007 in the United States.
2. The beneficial effects of exercise on T2DM are well documented as regards control of glucose, body mass index, lipids, hypertension, and changes in vascular endothelial function, carotid artery intima thickness media and arterial distensibility.
3. To date, there has been no study to assess the duration, frequency and intensity of exercise is necessary. The impact of training, aerobic exercise and resistance on the rate of cardiovascular events and morbidity and mortality is unclear.
4. The consensus is that there is no indication for routine detection of symptoms of coronary artery disease with T2DM stress ECG, stress imaging or coronary calcium scores. A stress test may be recommended to a patient known (previously diagnosed or symptomatic) coronary artery disease (CAD) begins an exercise program or if there is a change in clinical status or non-recent (≥ 2 years ) to the test. In patients with T2DM but without history of CAD, a stress test May be if there are any symptoms (chest pain or dyspnea of effort), a suspicion of CAD, peripheral arterial disease or ’stroke, the results of ECG ischemia or infarction, or before a vigorous exercise program.
5. Hypoglycemia is the most important potential complication of the year in T2DM. Self-monitoring of blood glucose is the most effective way to prevent and avoid episodes of hypoglycemia during exercise. Adequate replacement of carbohydrates has been proposed that the most effective strategy for most forms of exercise.
6. With prolonged exercise (> 60 minutes), the dose should be reduced by 20-30%. Among adolescents with insulin, a short sprint up after moderate-intensity exercise in May to oppose a further reduction in blood glucose. The effectiveness and feasibility of this has not been studied in elderly patients.
7. In a study to treat T2DM with a program of lifestyle (including increased physical activity and weight loss), patients with more than 3 levels of fasting blood glucose (FBG) <80 mg / dl or> 2/week hypoglycemic fate have their dose of hypoglycemic drugs reduce 50-100%. With control of the small reduced their dose of 25-50%, and when the FBG is> 100 mg / dl, no changes are made.
8. Peripheral vascular disease of the pipe and small vessels is common in T2DM. If the exercise would improve vascular function, care is needed to prevent and detect complications of the foot pursuit, especially those with neuropathy who are candidates for neurotrophic ulcers. It is important to avoid the high incidence of reduced walking speed, weight reduction (eg, aquatic exercise, Ergometry recumbent cycle), and a selection of shoes. Patients who require regular inspections of foot care, and completed by the partners themselves.
9. Patients with T2DM previously sedentary should be encouraged to accumulate a minimum of energy expenditure of 1000 kcal / week, equivalent to at least 30 minutes of accumulated moderate physical activity on 5 days per week. To reduce cardiovascular risk, it is recommended that patients with T2DM accumulate a minimum of 150 minutes per week of at least moderate physical activity and / or 90 minutes per week of intensive cardio exercise at least. In addition, resistance training 3 times per week should be encouraged. The exercise should be completed at least 3 days per week, with the existence of no more than 2 consecutive days without training. During the years of resistance, all the muscle groups must be used, and patients need to move to 8-10 repetitions per set for a total of 3 games. An increase in the lives of other activities should also be encouraged.
10. Helping patients to the implementation of changes in lifestyle T2DM is the responsibility of doctors, which may be supplemented by diabetes educators, nurses, referral to behavioral specialists and exercise physiologists and exercise the use of telephone counseling. Patients should be encouraged to participate in community health centers. Financial, time and other obstacles in May limit the absorption of certain minority groups. Despite the obstacles of the environment are often cited as the main barriers to activity, including unsafe areas to walk, transport problems and lack of child care, some data suggest that lack of activity is linked to Influence of medical conditions and attitudes and knowledge of these issues.
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