Study on muscle loss in patients with type 2 diabetes and initial evaluation of the effectiveness of exercise intervention - 25

C2

History of giving birth to a baby ≥ 4 kg (for women)

Yes No

1

2

D3

Prehistoric

diagnose

diabetes

pregnancy

(for women)

Yes No

1

2

D4.1

History of smoking


Menopause for women

Yes No


…………… year old

1

2

………bags/year

D4.2


Time of diagnosis


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Study on muscle loss in patients with type 2 diabetes and initial evaluation of the effectiveness of exercise intervention - 25

D2


D4.4

Physical activity


Status

malnutrition

1. High level activity

2. Moderate level activity

3. Low level activity


1. Yes

2. No

D5

Prehistoric

or currently have lipid disorders

Yes No

1

2

D6

History of hypertension

Yes No

1

2

D7

History of other diseases

Yes No

1

2

D4.3

 5.

Asthma/COPD

 8. Chronic kidney disease

 6. Kidney failure

 2. Accident


 9. Knee osteoarthritis

cerebral circuit

 6. Dilution


 3. Stuffing

bone

 10. Other

myocardial blood

 7. Pathology


 4. Accident

thyroid


cerebral circuit



 1. Angina


D8

Use of drugs:

Diabetes medication

1.Metformin …………….tablets/day

4. DP inhibition

2.Sunfunylurea……………tablets/day

5.SGLT2…

3.Alphaglucosidase……………….tablets/day

6.Injected insulin: yes/no, Total dose ……………..unit/day

 One stitch  Two stitches  Three stitches

Blood pressure medication

1.Calcium channel blocker…….tablet/day

4. Beta blockers……….

2. ACE inhibitors: ….

……….............tablets/day

5.Diuretic……day

3. AT1 receptor blocker………tablet/day

6.Other…………..tablets


Lipid medication

1.Simvastatin …..…tablets/day

4. Artervastatin ……

day

2. Fenofibrate ……...tablets/day

5. Rosuvastatin… vi

3.Ezetimide………………tablets/day

Eye examination: for patients participating in exercise


P4………


…………


n/day


…….tablet/


/ day


……tablets/day


Medical record code………………………Patient code………………………

E. CLINICAL AND PARACLINICAL INDICATORS

Index

0 months

After 12 months


Height (m)




Weight (kg)




Waist (cm)




Hip circumference (cm)




Resting blood pressure (mmHg)



Heart rate



Hand grip force P (kg) L1

L2




L2



6 m walking time



Hand grip force T (kg) L1



Index

0 months

After 3

month

After 6

month

After 9

month

After 12 months

Glucose (mmol/l)











Triglycerides (mmol/l)






Cholesterol lTP (mmol/l)






LDL C

(mmol/l)






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