Drugs used in metabolic disorders.

Diabetes mellitus is quantitatively the most frequently occurring important metabolic disorder, and exercise has always played an important role in the management of diabetic patients. Exercise increases insulin sensitivity and enhances glucose uptake into muscle. However, the insulin-dependent diabetic is at risk of developing hypoglycemia during exercise. This, in part, is due to the enhanced uptake of insulin from the injection site during exercise and an increased delivery of insulin to the liver, inhibiting hepatic glycogenolysis. Also discussed in this review are drugs, thyroid disease and exercise, anabolic steroids and exercise, glucocorticoids, plasma cortisol and the suppression of cortisol responses to exercise in patients on high-dose steroid therapy.