Muscle Health Research Centre, York University, Toronto, ON, Canada.
Royal Berkshire NHS Foundation Trust Centre for Diabetes and Endocrinology, Royal Berkshire Hospital, Reading, UK.
Lancet Diabetes Endocrinol. 2017 May;5(5):377-390. doi: 10.1016/S2213-8587(17)30014-1. Epub 2017 Jan 24.
Type 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week. Regular exercise can improve health and wellbeing, and can help individuals to achieve their target lipid profile, body composition, and fitness and glycaemic goals. However, several additional barriers to exercise can exist for a person with diabetes, including fear of hypoglycaemia, loss of glycaemic control, and inadequate knowledge around exercise management. This Review provides an up-to-date consensus on exercise management for individuals with type 1 diabetes who exercise regularly, including glucose targets for safe and effective exercise, and nutritional and insulin dose adjustments to protect against exercise-related glucose excursions.
1 型糖尿病的管理具有挑战性,原因涉及多种生理和行为因素。经常锻炼很重要,但对于 1 型糖尿病患者和医疗保健提供者来说,管理不同形式的体育活动尤其困难。1 型糖尿病患者的活动量往往与普通人群一样少,很大一部分人无法保持健康的体重,也无法达到每周至少进行一定量的中等强度至剧烈有氧运动的目标。经常锻炼可以改善健康和幸福感,并有助于个人实现目标的血脂水平、身体成分和健身以及血糖目标。然而,对于糖尿病患者来说,可能存在一些额外的运动障碍,包括对低血糖的恐惧、血糖控制丧失以及对运动管理的了解不足。这篇综述提供了关于经常锻炼的 1 型糖尿病患者运动管理的最新共识,包括安全有效运动的血糖目标,以及营养和胰岛素剂量调整以防止与运动相关的血糖波动。