Berger M, Berchtold P
Bibl Nutr Dieta. 1979(27):41-54. doi: 10.1159/000402369.
The effects of physical activity on blood glucose homeostasis in diabetes mellitus and the potential benefits of exercise in the treatment of diabetic patients, are reviewed. Mild physical exercise results in a fall of blood glucose levels in controlled diabetic patients; this acute effect of exercise might be used in particular to inhibit the rise of blood glucose seen in insulin-treated diabetics after food intake. In contrast, physical activity will further deteriorate the metabolic situation in decompensated diabetic patients by an increase in blood glucose and a rapid aggravation of ketosis. On the other hand exercise potentiates the blood glucose lowering effect of subcutaneously injected insulin; therefore precautions have to be taken in order to avoid hypoglycemia in insulin-dependent diabetics especially during and after more strenous exercise. In juvenile-type diabetes, physical activity can be used as an efficient therapeutic adjunct only in cooperative, well-instructed patients who are used to check their metabolic situation on a regular basis. Physical training increases the tissues' sensitivity towards (endogenous) insulin. Hence, in addition to the diet, training might represent the most appropriate treatment in maturity onset-type diabetic patients. However, direct evidence for an improvement of glucose tolerance in diabetic patients by physical training is still lacking. In order to formulate detailed, generally applicable recommendations on how to carry out a useful therapeutic program of physical exercise and/or training in diabetic patients, further clinical studies assessing the quantitative effects of physical activity on carbohydrate metabolism are needed.
本文综述了体育活动对糖尿病患者血糖稳态的影响以及运动在糖尿病患者治疗中的潜在益处。轻度体育锻炼可使血糖得到控制的糖尿病患者的血糖水平下降；运动的这种急性效应尤其可用于抑制胰岛素治疗的糖尿病患者进食后出现的血糖升高。相反，体育活动会使失代偿性糖尿病患者的代谢状况进一步恶化，导致血糖升高和酮症迅速加重。另一方面，运动可增强皮下注射胰岛素的降血糖作用；因此，必须采取预防措施，以避免胰岛素依赖型糖尿病患者尤其是在剧烈运动期间和之后发生低血糖。在青少年型糖尿病中，体育活动仅可作为一种有效的治疗辅助手段用于配合良好、指导有方且习惯定期检查自身代谢状况的患者。体育锻炼可提高组织对（内源性）胰岛素的敏感性。因此，除饮食外，锻炼可能是成年发病型糖尿病患者最合适的治疗方法。然而，目前仍缺乏体育锻炼改善糖尿病患者糖耐量的直接证据。为了就如何在糖尿病患者中开展有益的体育锻炼和/或训练治疗方案制定详细的、普遍适用的建议，需要进一步开展临床研究，评估体育活动对碳水化合物代谢的定量影响。
