Service de médecine du sport et des explorations fonctionnelles, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
Diabetes Metab. 2013 May;39(3):205-16. doi: 10.1016/j.diabet.2013.03.005. Epub 2013 May 2.
Although regular physical activity is an integral part of T2D management, few diabetic patients have a sufficient level of physical activity. However over the past decade or so, the beneficial effects of regular physical activity have been well demonstrated, both in T2D prevention (50% reduction in the incidence of T2D in subjects with high metabolic risk) as well as T2D management for the improvement of glycaemic control (mean 0.7% improvement of HbA1c) and the reduction of T2D-related comorbidities (improvement in blood pressure values and lipid profile, decrease in insulin resistance). Physical activity has both acute effects (effects of one exercise session) and more prolonged effects of exercise when it is repeated on a regular basis (training effect). In addition, the physical activity recommendations have been extended to a wide range of physical activities (by combining both endurance and muscle strengthening exercises), thus varying the physical activity practiced according to the patient's available time, practice sites, preferences and interests. Following a pathophysiology review, the effects of physical activity will be discussed and presented in terms of evidence-based medicine. The recommendations will be defined and practical prescribing information will be suggested, while taking into account that clinicians are concerned with answering questions regarding how, where and with whom: how can patients be motivated to practice a physical activity over the long-term? And how can qualified exercise trainers and appropriate practice settings be found?
虽然有规律的身体活动是 2 型糖尿病管理的一个组成部分,但很少有糖尿病患者有足够的身体活动水平。然而,在过去的十年左右,有规律的身体活动的有益效果得到了很好的证明,无论是在 2 型糖尿病预防(代谢风险高的受试者中 2 型糖尿病的发病率降低 50%)还是 2 型糖尿病管理,以改善血糖控制(糖化血红蛋白平均改善 0.7%)和减少 2 型糖尿病相关并发症(改善血压值和血脂谱,降低胰岛素抵抗)。身体活动既有急性效应(一次运动的效应),也有规律重复运动时的更持久效应(训练效应)。此外,身体活动建议已扩展到广泛的身体活动(通过将耐力和肌肉强化运动结合起来),从而根据患者的可用时间、实践地点、喜好和兴趣,改变所进行的身体活动。在对病理生理学进行回顾后,将根据循证医学讨论身体活动的效果。将定义建议,并提供实用的处方信息,同时考虑到临床医生关注的是如何、在哪里以及与谁回答问题:如何使患者能够长期坚持身体活动?如何找到合格的运动训练师和合适的实践场所?