Cardiopulmonary exercise testing-guided exercise protocols based on Holistic Integrative Physiology and Medicine...

Type II diabetes mellitus (T2DM) is characterized by glucose metabolic dysregulation, which may be addressed through integrative physiological interventions. Guided by Holistic Integrative Physiology and Medicine (HIPM) theory, this study investigates dynamic blood glucose changes in 11 T2DM patients with chronic comorbidities before and after cardiopulmonary exercise testing (CPET)-prescribed exercise to identify optimal multifactorial glycemic control strategies.

Eleven patients with T2DM who underwent 11 T2DM patients (2020-2022, Fuwai Hospital) underwent CPET for exercise intensity prescription. Continuous ambulatory blood glucose monitoring was conducted for each participant. Various parameters, including their fasting and postprandial peak glucose levels, exercise start and end times, post-exercise relative lows, rebound peak, low before eating fruits and vegetables at lunch, blood glucose levels, and the corresponding times at which carbohydrates were eaten, were observed and recorded. The time before exercise started was considered the zero point, and the difference in blood glucose between each point and the start of exercise, as well as the percentage difference, were calculated. Analysis of variance (ANOVA) was used to compare time points and blood glucose data for the entire group. Paired samples t-tests were used to compare adjacent time points and blood glucose data.

All patients exhibited post-breakfast peak fasting plasma glucose. Exercise initiation induced significant declines in blood glucose, continuing to nadir post-exercise. Levels subsequently rose slightly to a secondary peak before gradually declining to a second nadir prior to fruit/veg intake. Pre-lunch carbohydrate intake was associated with stable euglycemia (all P<0.001).

HIPM-based lifestyle management (exercise, nutrition, rest) rapidly modulates hyperglycemia in T2DM patients. Exercise-induced metabolic improvements enhance respiratory-circulatory homeostasis, providing a mechanistic basis for integrated chronic disease management strategies.