Rusavý Z, Lacigová S, Srámek V, Novák I, Tĕsínský P
I. interní klinika FN, Plzen.
Cas Lek Cesk. 1995 May 3;134(9):270-2.
Although there is no doubt about the benefit of physical exercise in diabetic patients, risks of exercise are known in particular in type 1 diabetics. The purpose of the investigation was to assess the optimal time of exercise in relation to food intake and insulin administration in type 1 diabetics treated by intensified insulin regimens.
The group comprised 31 type 1 diabetic patients without complications (21 women, 11 men) mean age 26 years, range 18-32 years with a mean duration of diabetes of 9 +/- 5.3 years and a BMI of 24.7 +/- 2.3. The patients were treated by intensified insulin regimens. In order to evaluate the blood sugar reaction they were subjected to a physical load amounting to 50% of the maximal oxygen consumption (VO2max) after exercise in the morning on fasting (state I), after administration of an insulin bolus and after breakfast (stage II) and after administration of a snack containing 20 g carbohydrate without insulin administration (stage III). The results of the blood sugar level during the 30th minute and during the fourth hour of the investigation are presented as per cent of the initial blood sugar level. Stage I ((10.1 mmol/l, SD = 5.2, 94%, SD = 54, 107%, SD = 50), stage II (9.16 mmol/l, SD = 5.1, 131%, SD = 86, 135%, SD = 97) and stage III (7.66 mmol/l, SD = 3.9, 189%, SD = 150, 153%, SD = 97). Processing of the results by Wilcoxon's test revealed a statistically significant difference of the blood sugar level after the load only between stages I and III (p < 0.01).
In type 1 diabetics treated by intensified insulin regimens the authors did not reveal a different response of the blood sugar level to loads on fasting or after a meal and insulin. Thus it is not necessary to respect previous recommendations: to take exercise 30-60 minutes after a meal, but according to individual needs of the patients.
尽管体育锻炼对糖尿病患者有益这一点毋庸置疑，但运动风险尤其在1型糖尿病患者中是已知的。本研究的目的是评估在接受强化胰岛素治疗方案的1型糖尿病患者中，与食物摄入和胰岛素给药相关的最佳运动时间。
该组包括31例无并发症的1型糖尿病患者（21名女性，11名男性），平均年龄26岁，年龄范围18 - 32岁，糖尿病平均病程9 ± 5.3年，体重指数为24.7 ± 2.3。患者接受强化胰岛素治疗方案。为了评估血糖反应，他们在空腹状态下（状态I）、注射胰岛素推注后和早餐后（阶段II）以及在不注射胰岛素的情况下摄入含20克碳水化合物的零食后（阶段III），进行相当于最大耗氧量（VO2max）50%的体力负荷运动。研究第30分钟和第4小时的血糖水平结果以初始血糖水平的百分比表示。状态I（（10.1毫摩尔/升，标准差 = 5.2，94%，标准差 = 54，107%，标准差 = 50），阶段II（9.16毫摩尔/升，标准差 = 5.1，131%，标准差 = 86，135%，标准差 = 97）和阶段III（7.66毫摩尔/升，标准差 = 3.9，189%，标准差 = 150，153%，标准差 = 97）。通过威尔科克森检验对结果进行处理后发现，仅在状态I和阶段III之间负荷后的血糖水平存在统计学显著差异（p < 0.01）。
在接受强化胰岛素治疗方案的1型糖尿病患者中，作者未发现空腹或餐后及注射胰岛素后血糖水平对负荷的反应有差异。因此，不必遵循先前的建议：餐后30 - 60分钟进行运动，而是应根据患者的个体需求来安排。
