Exercise in the management of non-insulin-dependent diabetes mellitus

被引:81
作者
Wallberg-Henriksson, H [1 ]
Rincon, J [1 ]
Zierath, JR [1 ]
机构
[1] Karolinska Inst, Karolinska Hosp, Dept Clin Physiol, S-17176 Stockholm, Sweden
关键词
D O I
10.2165/00007256-199825010-00003
中图分类号
G8 [体育];
学科分类号
04 ; 0403 ;
摘要
The incidence of non-insulin-dependent diabetes mellitus (NIDDM) has increased worldwide during the last decades. despite the development of effective drug therapy and improved clinical diagnoses. NIDDM is one of the major causes of disability and death due to the complications accompanying this disease. For the well-being of the patient, and from a public healthcare perspective, the development of effective intervention strategies is essential in order to reduce the incidence of NIDDM and its resulting complications. For the patient, and fur society at large,early intervention programmes are beneficial, especially from a cost-benefit perspective. Physical activity exerts pronounced effects on substrate utilisation and insulin sensitivity, which in rum potentially lowers blood glucose and lipid levels. Exercise training also improves many other physiological and metabolic abnormalities that are associated with NIDDM such as lowering body fat, reducing blood pressure and normalising dyslipoproteinaemia. Clearly, regular physical activity plays an important role in the prevention and treatment of NIDDM. Since physical activity has been shown in prospective studies to protect against the development of NIDDM, physical training programmes suitable for individuals at risk for NIDDM should be incorporated into the medical care system to a greater extent. One general determinant in a strategy to develop a preventive programme for NIDDM is to establish a testing programme which includes (V) over dot O-2max determinations for individuals who are at risk of developing NIDDM. Before initiating regular physical training for people with NIDDM, a complete physical examination aimed at identifying any long term complications of diabetes is recommended. All individuals above the age of 35 years should perform an exercise stress test before engaging in all exercise programme which includes moderate to vigorously intense exercise. The stress test will identify individuals with previously undiagnosed ischaemic heart disease and abnormal blood pressure responses. It is important to diagnose proliferative retinopathy, microalbuminuria, peripheral and/or autonomic neuropathy in patients with NIDDM before they participate in an exercise programme. If any diabetic complications are present, the exercise protocol should be modified accordingly. The exercise programme should consist of moderate intensity aerobic exercise. Resistance training and high intensity exercises should only be performed by individuals without proliferative retinopathy or hypertension. Once enrolled in the exercise programme, the patient must be educated with regard to proper footwear and daily foot inspections. Fluid intake is of great importance when exercising for prolonged periods or in warm and humid environments. With the proper motivation and medical supervision, people with NIDDM can enjoy regular physical exercise as a means of enhancing metabolic control and improving insulin sensitivity.
引用
收藏
页码:25 / 35
页数:11
相关论文
共 74 条
  • [11] EFFECTS OF INSULIN ON PERIPHERAL AND SPLANCHNIC GLUCOSE-METABOLISM IN NONINSULIN-DEPENDENT (TYPE-II) DIABETES-MELLITUS
    DEFRONZO, RA
    GUNNARSSON, R
    BJORKMAN, O
    OLSSON, M
    WAHREN, J
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1985, 76 (01) : 149 - 155
  • [12] INFLUENCE OF PLASMA-GLUCOSE AND INSULIN CONCENTRATION ON PLASMA-GLUCOSE CLEARANCE IN MAN
    DEFRONZO, RA
    FERRANNINI, E
    [J]. DIABETES, 1982, 31 (08) : 683 - 688
  • [13] THE TRIUMVIRATE - BETA-CELL, MUSCLE, LIVER - A COLLUSION RESPONSIBLE FOR NIDDM
    DEFRONZO, RA
    [J]. DIABETES, 1988, 37 (06) : 667 - 687
  • [14] AN INVITRO HUMAN MUSCLE PREPARATION SUITABLE FOR METABOLIC STUDIES - DECREASED INSULIN STIMULATION OF GLUCOSE-TRANSPORT IN MUSCLE FROM MORBIDLY OBESE AND DIABETIC SUBJECTS
    DOHM, GL
    TAPSCOTT, EB
    PORIES, WJ
    DABBS, DJ
    FLICKINGER, EG
    MEELHEIM, D
    FUSHIKI, T
    ATKINSON, SM
    ELTON, CW
    CARO, JF
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1988, 82 (02) : 486 - 494
  • [15] ABDOMINAL OBESITY AND PHYSICAL INACTIVITY AS RISK-FACTORS FOR NIDDM AND IMPAIRED GLUCOSE-TOLERANCE IN INDIAN, CREOLE, AND CHINESE MAURITIANS
    DOWSE, GK
    ZIMMET, PZ
    GAREEBOO, H
    ALBERTI, KGMM
    TUOMILEHTO, J
    FINCH, CF
    CHITSON, P
    TULSIDAS, H
    [J]. DIABETES CARE, 1991, 14 (04) : 271 - 282
  • [16] MECHANISM OF ENHANCED INSULIN SENSITIVITY IN ATHLETES - INCREASED BLOOD-FLOW, MUSCLE GLUCOSE-TRANSPORT PROTEIN (GLUT-4) CONCENTRATION, AND GLYCOGEN-SYNTHASE ACTIVITY
    EBELING, P
    BOUREY, R
    KORANYI, L
    TUOMINEN, JA
    GROOP, LC
    HENRIKSSON, J
    MUECKLER, M
    SOVIJARVI, A
    KOIVISTO, VA
    [J]. JOURNAL OF CLINICAL INVESTIGATION, 1993, 92 (04) : 1623 - 1631
  • [17] Edelman Steven V., 1996, P647
  • [18] HORMONAL RESPONSES AND FUTURE TREATMENT OF NON-INSULIN-DEPENDENT DIABETES-MELLITUS (NIDDM)
    EFENDIC, S
    OSTENSON, CG
    [J]. JOURNAL OF INTERNAL MEDICINE, 1993, 234 (02) : 127 - 138
  • [19] EFENDIC S, 1994, DIABETES METAB, V20, P81
  • [20] A COMPARISON OF LIFESTYLE EXERCISE, AEROBIC EXERCISE, AND CALISTHENICS ON WEIGHT-LOSS IN OBESE CHILDREN
    EPSTEIN, LH
    WING, RR
    KOESKE, R
    VALOSKI, A
    [J]. BEHAVIOR THERAPY, 1985, 16 (04) : 345 - 356