RESUMO
Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
Assuntos
Diabetes Mellitus Tipo 1 , Exercício Físico/fisiologia , Glicemia , Contraindicações , Humanos , Necessidades NutricionaisAssuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Hemoglobinas Glicadas/metabolismo , Pirazinas/uso terapêutico , Triazóis/uso terapêutico , Inibidores da Dipeptidil Peptidase IV/farmacologia , Quimioterapia Combinada , Feminino , Gliclazida/uso terapêutico , Fator 1-alfa Nuclear de Hepatócito/efeitos dos fármacos , Humanos , Hipoglicemiantes/uso terapêutico , Pessoa de Meia-Idade , Pioglitazona , Pirazinas/farmacologia , Rosiglitazona , Fosfato de Sitagliptina , Tiazolidinedionas/uso terapêutico , Triazóis/farmacologiaRESUMO
PURPOSE OF REVIEW: People with type 1 diabetes want to enjoy the benefits of sport and exercise, but management of diabetes in this context is complex. An understanding of the physiology of exercise in health, and particularly the control of fuel mobilization and metabolism, gives an idea of problems that may arise in managing diabetes for sport and exercise. RECENT FINDINGS: Exercise is complicated both by hypoglycaemia and hyperglycaemia in particular circumstances. Recent data demonstrate both early and late hypoglycaemia associated with endurance exercise and also give new insights into fuel use during exercise in diabetes. These data also provide potential explanations for the reduction in maximal exercise capacity sometimes observed in people with diabetes, although it should be noted that this observation is by no means universal. SUMMARY: Advances in the understanding of exercise physiology allow the development of management strategies that aim to help athletes with diabetes achieve appropriate metabolic control during exercise. These metabolic strategies, coupled with observations from each athlete's own experience, give a basis for individualized advice that will help athletes with diabetes to fulfil their full potential.