Lumb Alistair N, Gallen Ian W
Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK.
Curr Opin Endocrinol Diabetes Obes. 2009 Apr;16(2):150-5. doi: 10.1097/MED.0b013e328328f449.
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.
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.
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.
1型糖尿病患者希望享受运动带来的益处，但在此背景下糖尿病的管理较为复杂。了解健康状态下运动的生理学机制，尤其是燃料动员和代谢的控制，有助于认识在糖尿病患者进行运动时可能出现的问题。
在特定情况下，低血糖和高血糖都会使运动变得复杂。近期数据表明，耐力运动既会引发早期低血糖，也会导致晚期低血糖，同时也为糖尿病患者运动期间的燃料利用提供了新见解。这些数据还为有时在糖尿病患者中观察到的最大运动能力下降提供了潜在解释，不过需要注意的是，这种观察结果并非普遍存在。
对运动生理学理解的进展使得管理策略得以发展，旨在帮助糖尿病运动员在运动期间实现适当的代谢控制。这些代谢策略，再结合每位运动员自身的经验观察，为个性化建议提供了依据，有助于糖尿病运动员充分发挥潜力。
