最大摄氧量） 建议糖尿病患者的运动处方课件.ppt

Exercise Prescription and Dietary Control for Diabetes Mellitus and Obesity CC ChowDepartment of Medicine Therapeutics Prince of Wales Hospital Resistance Exercise Activities that use muscular strength to move a weight or work against a resistive load. Examples include weight lifting and exercises using weight machines T2DM should be encouraged to perform RE 3x/week, targeting all major muscle groups, progressing to 3 sets of 8-10 repetitions at a weight that cannot be lifted more than 8-10 times Proven improving glycaemic control by improving insulin sensitivity to about the same extent as aerobic exercise Largely safe for patients with high risk for CVD Evaluation of the diabetic patient before recommending an exercise program Not as a routine if CAD risk is low Usually no need if just brisk walking Take extra precautions if Uncontrolled HT Severe autonomic neuropathy Severe peripheral neuropathy Prepoliferative/proliferative retinopathy or macular oedema A graded exercise test with ECG monitoring should be seriously considered before undertaking aerobic physical activity with an intensity exceeding the demands of everyday living (more intense than brisk walking) in previously sedentary diabetic individuals whose 10-yr risk of a coronary event is ?10% Estimated directly using the UKPDS Risk Engine (www.dtu.ox.ac.uk/riskengine/download.htm) Assessed if any of the following criteria: Age 40 yrs, +/- CVD risk factors other than DM Age 30 yrs and T1 or T2 DM 10 yrs’ duration HT Cigarette smoking Dyslipidaemia Prepoliferative/proliferative retinopathy Nepropathy, including microalbuminuria Any of the following, regardless of age Known or suspected CAD, CVD +/- PVD Autonomic neuropathy Advanced nephropathy with renal failure Exercise in the presence of specific long-term diabetic complication Advanced retinopathy Vigorous aerobic or resistance exercise may be contraindicated because of the risk of triggering vitreous haemorrhage Severe peripheral neuropathy Bes