梁嘉琳，尚治新，严金霞，梁干雄.步行运动对1型糖尿病残余胰岛β细胞功能及血糖控制的影响[J].中华物理医学与康复杂志,2018,40(8):604-607
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| 步行运动对1型糖尿病残余胰岛β细胞功能及血糖控制的影响 |
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| DOI： |
| 中文关键词: 步行运动； 糖尿病1型； 血糖控制； 糖化血红蛋白 C肽 |
| 英文关键词: Walking Diabetes mellitus, type 1 Glycemic control Beta cells C-peptide |
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| 中文摘要: |
| 目的 探讨步行运动对1型糖尿病患者残存β细胞功能及血糖控制的影响。 方法 纳入平时步行数<5000步/天的1型糖尿病患者共117例，对患者进行运动健康教育。根据4个月随访时的平均步数将患者分成运动不足组（<5000步/天），基本运动组（5000～10000步/天）和运动活跃组（>10000步/天），其中运动不足组34例（男占23.5%）、基本运动组45例（男占40.0%）、运动活跃组38例（男占52.6%）。采用空腹C肽、餐后C肽、餐后C肽/血糖比值评估患者的β细胞功能，采用糖化血红蛋白、胰岛素剂量调整糖化血红蛋白评估患者的血糖控制情况。 结果 随访时β细胞功能和血糖控制随着步行运动量的增加而改善，即随着步行运动量的增加，空腹C肽（趋势P<0.05）、餐后C肽（趋势P<0.05）及餐后C肽/血糖比值（趋势P<0.05）呈升高趋势，而糖化血红蛋白（趋势P<0.05）、胰岛素剂量调整糖化血红蛋白（趋势P<0.05）呈下降趋势。协方差分析均衡入组时的差异后，仍然发现不同分组患者随访时的β细胞功能和血糖控制的差异有统计学意义（P<0.05）。线性回归分析显示，步行运动量大能独立预测随访时更好的β细胞功能（空腹C肽：β=0.157，P=0.005；餐后C肽：β=0.258，P<0.001；餐后C肽/血糖比值：β=0.284，P<0.001）和血糖控制（糖化血红蛋白：β=-0.223，P=0.039；胰岛素剂量调整糖化血红蛋白：β=-0.463，P<0.001）。 结论 步行运动可有效改善1型糖尿病患者残存β细胞功能及血糖控制。 |
| 英文摘要: |
| Objective To explore the effect of walking on residual beta cell function and glycemic control in patients with type 1 diabetes mellitus. Methods A total of 117 type 1 diabetes mellitus patients who usually walked less than 5000 steps per day were given health education about exercise and divided into three groups according to their self-estimates of the number of walking steps they had taken daily in the previous 4 months: an absent exercise group (< 5000 steps/day), a basic exercise group (5000-10000 steps/day) and an active exercise group (> 10000 steps/day). Among them, 34 were in absent group (23.5% for males), 45 were in basis exercise group (40.0% for males) and 38 were in active exercise group (52.6% for males). Fasting C-peptide, postprandial C-peptide, and postprandial C-peptide to glucose ratio were used to evaluate the residual beta cell function, while glycated hemoglobin A1c (HbA1c) and insulin dose-adjusted HbA1c (IDAA1c) were used to evaluate their glycemic control. Results The beta cell function and glycemic control showed a tendency to improve with increases in the number of walking steps. Fasting C-peptide, postprandial C-peptide and the postprandial C-peptide to glucose ratio also increased significantly, while HbA1c and IDAA1c decreased significantly. After balancing the initial difference in the analysis of covariance, significant differences were still found among the 3 groups in the subjects′ beta cell function and glycemic control during the follow-up. Linear regression showed that a large number of steps independently predicted better beta cell function. Conclusions In patients with type 1 diabetes mellitus, walking exercise may be effective for improving residual beta cell function and glycemic control. |
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