Farinha Juliano Boufleur, Krause Maurício, Rodrigues-Krause Josianne, Reischak-Oliveira Alvaro
School of Physical Education, Physiotherapy and Dance, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Department of Physiology, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Med Hypotheses. 2017 Jul;104:147-153. doi: 10.1016/j.mehy.2017.05.033. Epub 2017 May 31.
Type 1 diabetes mellitus (T1DM) is characterized by the loss of insulin secreting cells due to a directed autoimmune process, which is linked to oxidative stress and inflammation. Exercise training is known to induce several benefits by reducing inflammation and improving antioxidant defenses. In this context, exercise training may be considered as an efficient and relatively inexpensive non-pharmacological tool for diabetes treatment, added to the usual insulin administration. Unfortunately, most people with T1DM do not reach the recommended levels of physical activity due to concerns with hypoglycemic episodes. Recent data have demonstrated that exercise sessions composed by strength exercises or high-intensity interval exercise reduce the risk of hypoglycemia during and after the physical effort, when compared with continuous aerobic exercise in insulin-dependent patients. However, no studies have tested the chronic effects of this combination of protocols on health-related markers yet. Herein, we suggest a combination of hypertrophic strength exercises (3 sets at 8-RM) with a high-intensity interval protocol (10×60-s bouts at ∼90% HR interspersed with 60s recovery) in the same exercise session, three times per week, for T1DM patients free of micro and macrovascular complications. Our hypothesis is that this training protocol may minimize the exercise-associated rapid drop of glucose levels in T1DM, due to glucoregulatory hormones and transient reduction of insulin-mediated glucose uptake. This training is also likely to cover long-term glycaemic, bioenergetic, neuromuscular and cardiorespiratory adaptations, implicating in improved health and decreased risk of micro and macro complications.
1型糖尿病（T1DM）的特征是由于定向自身免疫过程导致胰岛素分泌细胞丧失，这与氧化应激和炎症有关。已知运动训练可通过减轻炎症和改善抗氧化防御带来多种益处。在这种情况下，运动训练可被视为一种有效且相对廉价的非药物治疗糖尿病的工具，可作为常规胰岛素给药的补充。不幸的是，大多数T1DM患者由于担心低血糖发作而未达到推荐的身体活动水平。最近的数据表明，与胰岛素依赖型患者进行持续有氧运动相比，由力量训练或高强度间歇训练组成的运动时段可降低运动期间和运动后低血糖的风险。然而，尚无研究测试这种方案组合对健康相关指标的长期影响。在此，我们建议对于无微血管和大血管并发症的T1DM患者，在同一运动时段将肥大力量训练（8次重复最大重量，3组）与高强度间歇训练方案（10×60秒的运动时段，心率约为90%，中间穿插60秒恢复时间）相结合，每周进行三次。我们的假设是，由于血糖调节激素和胰岛素介导的葡萄糖摄取的短暂减少，这种训练方案可能会使T1DM患者运动相关的血糖水平快速下降最小化。这种训练还可能涵盖长期的血糖、生物能量、神经肌肉和心肺适应，意味着健康状况改善以及微血管和大血管并发症风险降低。
