Rogers M A
Section of Applied Physiology, Washington University School of Medicine, St. Louis, MO 63110.
Med Sci Sports Exerc. 1989 Aug;21(4):362-8.
The evidence that exercise reduces resistant to the action of insulin has generated interest in the possibility that endurance exercise training may be a worthwhile primary therapeutic intervention in the treatment of mild non-insulin-dependent diabetes mellitus (NIDDM). Unfortunately, the results of several studies of exercise training in NIDDM have been discouraging since improvements in oral glucose tolerance (OGT) did not occur or were quite modest even though insulin resistance was reduced. Recently it was determined that 12 months of endurance exercise training at 75-90% of VO2max could normalize OGT in men with mild NIDDM when the post-training OGTT was performed within 18 h of the last bout of exercise. This, coupled with the fact that the enhanced action of insulin is lost in trained persons within a few days of cessation of training, suggests that improved glucose tolerance in NIDDM patients may be partly due to the persistent effects of the last bouts of exercise. Acute exercise in the form of 7 d of intense walking/cycling has been shown to improve glucose tolerance despite a significantly smaller increase in plasma insulin levels during the OGTT in NIDDM. Apparently, the improvement in OGT was due to a decrease in resistance to insulin over the short term since no changes in body weight, body fat, or VO2max took place. Thus, acute exercise of sufficient intensity and duration can increase peripheral insulin action and may contribute to the effects of long-term exercise training on improvement in OGT and the amelioration of insulin resistance in patients with NIDDM.
有证据表明运动可降低对胰岛素作用的抵抗，这引发了人们对于耐力运动训练可能是治疗轻度非胰岛素依赖型糖尿病（NIDDM）的一种有价值的主要治疗干预措施的兴趣。不幸的是，几项针对NIDDM患者运动训练的研究结果令人沮丧，因为即使胰岛素抵抗有所降低，但口服葡萄糖耐量（OGT）并未改善或改善程度甚微。最近有研究确定，对于轻度NIDDM男性患者，当在最后一次运动后18小时内进行训练后的口服葡萄糖耐量试验（OGTT）时，以最大摄氧量（VO2max）的75 - 90%进行12个月的耐力运动训练可使OGT恢复正常。这一点，再加上训练者在停止训练后的几天内胰岛素增强的作用就会消失这一事实，表明NIDDM患者葡萄糖耐量的改善可能部分归因于最后几次运动的持续影响。研究表明，以7天的高强度步行/骑自行车形式进行的急性运动可改善葡萄糖耐量。尽管在NIDDM患者的OGTT期间血浆胰岛素水平的升高幅度明显较小。显然，OGT的改善是由于短期内胰岛素抵抗的降低，因为体重、体脂或VO2max均未发生变化。因此，足够强度和持续时间的急性运动可增加外周胰岛素作用，并可能有助于长期运动训练对改善NIDDM患者OGT及减轻胰岛素抵抗的效果。
