Horton William B, Subauste Jose S
Department of Medicine, University of Mississippi Medical Center, Mississippi, United States.
Department of Medicine, University of Mississippi Medical Center, Mississippi, United States; Division of Endocrinology, University of Mississippi Medical Center, Mississippi, United States; Department of Medicine, G.V. Montgomery VA Medical Center, Mississippi, Jackson, United States.
Int J Endocrinol Metab. 2016 Mar 26;14(2):e36091. doi: 10.5812/ijem.36091. eCollection 2016 Apr.
Type 1 diabetes mellitus (T1DM) results from a highly specific immune-mediated destruction of pancreatic β cells, resulting in chronic hyperglycemia. For many years, one of the mainstays of therapy for patients with T1DM has been exercise balanced with appropriate medications and medical nutrition. Compared to healthy peers, athletes with T1DM experience nearly all the same health-related benefits from exercise. Despite these benefits, effective management of the T1DM athlete is a constant challenge due to various concerns such as the increased risk of hypoglycemia. This review seeks to summarize the available literature and aid clinicians in clinical decision-making for this patient population.
PubMed searches were conducted for "type 1 diabetes mellitus AND athlete" along with "type 1 diabetes mellitus AND exercise" from database inception through November 2015. All articles identified by this search were reviewed if the article text was available in English and related to management of athletes with type 1 diabetes mellitus. Subsequent reference searches of retrieved articles yielded additional literature included in this review.
The majority of current literature available exists as recommendations, review articles, or proposed societal guidelines, with less prospective or higher-order treatment studies available. The available literature is presented objectively with an attempt to describe clinically relevant trends and findings in the management of athletes living with T1DM.
Managing T1DM in the context of exercise or athletic competition is a challenging but important skill for athletes living with this disease. A proper understanding of the hormonal milieu during exercise, special nutritional needs, glycemic control, necessary insulin dosing adjustments, and prevention/management strategies for exercise-related complications can lead to successful care plans for these patients. Individualized management strategies should be created with close cooperation between the T1DM athlete and their healthcare team (including a physician and dietitian).
1型糖尿病（T1DM）是由胰腺β细胞特异性免疫介导破坏所致，导致慢性高血糖。多年来，T1DM患者治疗的主要支柱之一是运动，并配合适当的药物和医学营养。与健康同龄人相比，患有T1DM的运动员从运动中获得几乎所有相同的健康相关益处。尽管有这些益处，但由于低血糖风险增加等各种问题，对患有T1DM的运动员进行有效管理仍是一项持续的挑战。本综述旨在总结现有文献，并帮助临床医生针对该患者群体进行临床决策。
从数据库建立到2015年11月，在PubMed上搜索“1型糖尿病与运动员”以及“1型糖尿病与运动”。如果文章文本为英文且与1型糖尿病运动员的管理相关，则对该搜索识别出的所有文章进行综述。对检索到的文章进行后续参考文献搜索，得到了本综述中包含的其他文献。
现有大多数文献为建议、综述文章或拟议的社会指南，前瞻性或高阶治疗研究较少。现有文献客观呈现，试图描述T1DM运动员管理中临床相关的趋势和发现。
在运动或体育比赛背景下管理T1DM对患有这种疾病的运动员来说是一项具有挑战性但很重要的技能。正确理解运动期间的激素环境、特殊营养需求、血糖控制、必要的胰岛素剂量调整以及运动相关并发症的预防/管理策略，可以为这些患者制定成功的护理计划。应在T1DM运动员及其医疗团队（包括医生和营养师）密切合作下制定个性化管理策略。
