中等强度间歇性运动联合二甲双胍治疗老年2型糖尿病的临床观察

Clinical observation of moderate intensity interval training combined with metformin in treatment of elderly patients with type 2 diabetes mellitus

目的探索中等强度间歇性运动(MIIT)联合二甲双胍对老年2型糖尿病(T2DM)患者血糖的影响。方法选取2021年3月—2023年3月于空军军医大学第一附属医院内分泌代谢科住院治疗的老年T2DM患者,将受试者随机分为观察组(n=46)和对照组(n=46)。对照组口服二甲双胍+静坐;观察组口服二甲双胍+MIIT,隔日训练1次。2组均治疗1周。比较2组MIIT时末梢血糖,首次MIIT后餐前、睡前末梢血糖及餐后最高末梢血糖。结果MIIT时末梢血糖时间与分组存在交互作用(P<0.001)。MIIT后10、30、50 min,观察组末梢血糖低于对照组(P<0.001)。与同组MIIT前比较,2组MIIT后10、30、50、70、90 min末梢血糖较低(P<0.05)。首次MIIT后,餐前和睡前末梢血糖分组与时间不存在交互作用(P>0.05)。分组对末梢血糖的主体效应差异有统计学意义,观察组末梢血糖较对照组低2.31 mmol/L(P<0.001)。时间因素对餐前和睡前末梢血糖的主效应差异无统计学意义(P>0.05)。餐后最高末梢血糖分组与时间存在交互作用(P<0.05)。与对照组相比,观察组MIIT后第27天餐后最高末梢血糖较低(P<0.001)。与MIIT前1天比较,2组MIIT后第17天餐后最高末梢血糖降低(P<0.05)。结论MIIT联合二甲双胍可能是控制老年T2DM患者血糖的有效策略。

Objective To explore the effects of moderate intensity interval training(MIIT)combined with metformin on blood glucose in elderly patients with type 2 diabetes mellitus(T2DM).Methods Elderly T2DM patients hospitalized in Department of Endocrinology and Metabolism of First Affiliated Hospital of Air Force Military Medical University from March 2021 to March 2023 were selected and randomly divided into observation group(n=46)and control group(n=46).The control group received oral metformin and meditation.The observation group took oral metformin and MIIT,and trained once every other day.Both groups were treated for 1 week.The peripheral blood glucose level during MIIT,peripheral blood glucose level before meals and before bed after the first MIIT,and maximal peripheral blood glucose level after the meal were compared between the two groups.Results There was an interaction between the peripheral blood glucose time and grouping during MIIT(P<0.001).At 10,30,50 min after MIIT,the levels of the peripheral blood glucose of the observation group was lower than those of the control group(P<0.001).Compared with the same group before MIIT,the levels of the peripheral blood glucose of both groups was lower at 10,30,50,70,90 min after MIIT(P<0.05).After the first MIIT,there was no interaction between pre-meal and bedtime peripheral blood glucose grouping and time(P>0.05).There was a statistically significant difference in the main effect of grouping on the peripheral blood glucose level,and the level of the peripheral blood glucose of the observation group was 2.31 mmol/L lower than that of the control group(P<0.001).There was no statistically significant difference(P>0.05)in the main effect of time factors on the levels of the peripheral blood glucose before meals and before bed.There was an interaction between the maximal postprandial peripheral blood glucose grouping and time(P<0.05).Compared with the control group,the maximal postprandial peripheral blood glucose level in the observation group was lower on days 2-7 after MIIT(P<0.001).Compared with the day before MIIT,the maximal postprandial peripheral blood glucose level decreased in both groups from 1 to 7 days after MIIT(P<0.05).Conclusion MIIT combined with metformin may be an effective strategy to control blood glucose in elderly patients with T2DM.