Corigliano Gerardo, Iazzetta Nicolangelo, Corigliano Marco, Strollo Felice
Diabetes Unit A.I.D. Naples.
Acta Biomed. 2006;77 Suppl 1:26-33.
Circulating insulin levels decrease and substrate glycogenolysis-mediated conversion into glucose increases just a few minutes after normal subjects start exercising, but during sustained physical activity muscles massively utilize blood glucose, thus causing glycogenolysis to increase further until the end of the session. After that, in order to get liver and muscle glycogen stores up to pre-exercise levels again, blood glucose is mostly utilized, thus causing late-onset hypoglycaemia in the absence of any extra carbohydrate supply and rebound hyperglycaemia after a while. This and other patho-physiological mechanisms are dealt with in the present paper, and practical hints are provided to the clinician to cope with children-specific adaptation phenomena to exercise in t1DM.
正常受试者开始运动几分钟后，循环胰岛素水平下降，底物糖原分解介导的葡萄糖转化增加，但在持续的体力活动中，肌肉大量利用血糖，从而导致糖原分解进一步增加，直至运动结束。之后，为了使肝脏和肌肉糖原储备再次恢复到运动前水平，大部分血糖被利用，因此在没有额外碳水化合物供应的情况下会导致迟发性低血糖，一段时间后会出现反弹性高血糖。本文讨论了这一病理生理机制，并为临床医生提供了应对1型糖尿病儿童运动特异性适应现象的实用建议。
