Diabetes mellitus and exercise.

The study deals with the subject of exercise in diabetic patients, with particular emphasis on acute physical stress in type--I and type--II diabetics. The principal task was to define metabolic changes as they occur in the diabetic subjected to acute stress induced by exercise, in comparison with non-diabetics; metabolic changes during prolonged stress as well as during the period of rest; and finally, to propose, on the basis of authors' experimental results and detailed literature research, appropriate rules of procedure for prescriptive exercise for the individual patient. There were 120 subjects divided into 8 groups. Using primarily a bicycle ergometer, the members of the individual groups were subjected to physical stress of various intensity and duration. A detailed analysis of each subject's metabolic response was performed, involving an assessment of 35 physiological and biochemical parameters, with main focus on determining biochemical changes. The study results are presented in detail both with respect to the metabolic response to a given stress in individual groups and comparatively for individual parameters with regard to specific stress rates and groups. Significant differences were found in the metabolic responses concerning the following parameters: acid-base balance, potassium, triglycerols, glucose, cholesterol, FFA, free glycerol, lactate, uric acid. On the basis of the results of experimental measurements, the following algorithm has been designed for prescribing exercise to diabetics: appropriate motivation; determination of the type of exercise; determination of the intensity of exercise; determination of the duration of exercise; respecting related contraindications and complications. A conclusion has been made that provided all possible risks and contraindications as well as prescription guidelines are respected, exercise is to be considered one of the basic principles of diabetes management.