Lenasi Helena, Klonizakis Markos
Institute of Physiology, Faculty of Medicine, University of Ljubljana, Slovenia.
Centre for Sport and Exercise Science, Sheffield Hallam University, UK.
Clin Hemorheol Microcirc. 2016;64(4):663-678. doi: 10.3233/CH-168022.
Diabetes mellitus (DM) is associated with cardiovascular complications. Impairment of glycemic control induces noxious glycations, an increase in oxydative stress and dearangement of various metabolic pathways. DM leads to dysfunction of micro- and macrovessels, connected to metabolic, endothelial and autonomic nervous system. Thus, assessing vascular reactivity might be one of the clinical tools to evaluate the impact of harmful effects of DM and potential benefit of treatment; skin and skeletal muscle microcirculation have usually been tested. Physical exercise improves vascular dysfunction through various mechanisms, and is regarded as an additional effective treatment strategy of DM as it positively impacts glycemic control, improves insulin sensitivity and glucose uptake in the target tissues, thus affecting glucose and lipid metabolism, and increases the endothelium dependent vasodilation. Yet, not all patients respond in the same way so titrating the exercise type individualy would be desirable. Resistance training has, apart from aerobic one, been shown to positively correlate to glycemic control, and improve vascular reactivity. It has been prescribed in various forms or in combination with aerobic training. This review would assess the impact of different modes of exercise, the mechanisms involved, and its potential positive and negative effects on treating patients with Type I and Type II DM, focusing on the recent literature.
糖尿病（DM）与心血管并发症相关。血糖控制受损会引发有害的糖基化反应、氧化应激增加以及各种代谢途径紊乱。糖尿病会导致微血管和大血管功能障碍，这与代谢、内皮和自主神经系统有关。因此，评估血管反应性可能是评估糖尿病有害影响及治疗潜在益处的临床工具之一；通常会检测皮肤和骨骼肌微循环。体育锻炼通过多种机制改善血管功能障碍，并且被视为糖尿病的一种额外有效治疗策略，因为它对血糖控制有积极影响，能提高胰岛素敏感性以及靶组织对葡萄糖的摄取，从而影响糖脂代谢，并增加内皮依赖性血管舒张。然而，并非所有患者的反应都相同，因此个性化调整运动类型是可取的。除有氧运动外，抗阻训练已被证明与血糖控制呈正相关，并能改善血管反应性。它已以各种形式开具处方或与有氧运动相结合。本综述将评估不同运动方式的影响、涉及的机制及其对治疗1型和2型糖尿病患者的潜在正负效应，重点关注近期文献。
