Eriksson J G
National Public Health Institute, Department of Epidemiology and Health Promotion, Helsinki, Finland.
Sports Med. 1999 Jun;27(6):381-91. doi: 10.2165/00007256-199927060-00003.
Exercise has long been considered a cornerstone in the treatment regimen for patients with type 2 (non-insulin-dependent) diabetes mellitus. Aerobic endurance exercise has traditionally been advocated as the most suitable exercise mode. Several exercise studies have evaluated the effect of exercise on insulin sensitivity and glycaemic control in patients with type 2 diabetes mellitus. However, the results obtained have been highly heterogeneous regarding the effect of exercise on insulin sensitivity and glycaemic control. Only in certain subgroups (e.g. patients with type 2 diabetes mellitus under 55 years of age, those with diabetes treated through diet and those who have diabetes with fairly good metabolic control), does exercise seem to be beneficial with regard to improvement in glycaemic control. There has been little research into the effects of resistance training on glucose metabolism in patients with type 2 diabetes mellitus compared with the amount of research involving aerobic endurance exercise. The incidence of type 2 diabetes mellitus increases with increasing age, partly because of the decline in muscle mass associated with aging. This corresponds with a decline in metabolic function, supporting the usefulness of resistance training. Available studies support the usefulness of resistance training in the treatment of type 2 diabetes mellitus. Therefore, based on the published studies reviewed, this author proposes that an optimal exercise programme for individuals with type 2 diabetes mellitus should include components that improve cardiorespiratory fitness, muscular strength and endurance, i.e. a combination of aerobic endurance training and circuit-type resistance training. Programmes combining various modes of exercise positively influence patient compliance with the exercise programme. The vast majority of patients with type 2 diabetes mellitus can undertake an individualised exercise programme without significantly increased risks of complications.
长期以来，运动一直被视为2型（非胰岛素依赖型）糖尿病患者治疗方案的基石。传统上，有氧耐力运动被认为是最合适的运动方式。多项运动研究评估了运动对2型糖尿病患者胰岛素敏感性和血糖控制的影响。然而，关于运动对胰岛素敏感性和血糖控制的影响，所获得的结果差异很大。只有在某些亚组中（例如55岁以下的2型糖尿病患者、通过饮食治疗的糖尿病患者以及代谢控制相当良好的糖尿病患者），运动似乎在改善血糖控制方面是有益的。与涉及有氧耐力运动的研究数量相比，关于抗阻训练对2型糖尿病患者糖代谢影响的研究较少。2型糖尿病的发病率随着年龄的增长而增加，部分原因是与衰老相关的肌肉量下降。这与代谢功能的下降相对应，支持了抗阻训练的有效性。现有研究支持抗阻训练在2型糖尿病治疗中的有效性。因此，基于所综述的已发表研究，本文作者建议，2型糖尿病患者的最佳运动方案应包括改善心肺适能、肌肉力量和耐力的组成部分，即有氧耐力训练和循环式抗阻训练的组合。结合多种运动方式的方案对患者坚持运动方案有积极影响。绝大多数2型糖尿病患者可以进行个体化运动方案，而不会显著增加并发症风险。
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