[Diabetes and sports].Wien Med Wochenschr 1993; 143(1):9-12WM
Through better understanding of the physiology of physical exercise in normal and diabetic subjects we can more closely define the significance of regular physical exercise in the treatment of diabetes. Although patients with type I and type II diabetes can obtain different advantages from regular physical exercise, this activity is in turn connected with different risks. The introduction of self-monitoring of blood glucose has though considerably eased management in relation to physical activity by type I diabetics. Essentially the risk to type I diabetics is that of developing hypoglycemia during or after exercise as well as the danger of a worsening of metabolic levels with the development of ketoacidosis. In type II diabetics the risk of hypoglycemia is less pronounced and in patients treated solely by dietary means the regulation of blood glucose presents no great problem. With these individuals regular physical activity can be implemented as a further therapeutic tool towards the normalisation of body weight and an improvement in insulin sensitivity. With appropriate training and self-control the potential hypoglycemia in type I diabetic patients can easily be avoided. For this reason regular physical exercise can be recommended as a cornerstone of therapy, both in the management of type I as well as type II diabetes. The positive effect of exercise is significantly better defined in regard to type II diabetics than with type I diabetics. In particular, regular physical exercise can be implemented as a supplement to caloric restriction for weight reduction and as a means to improve insulin sensitivity in the obese insulin-resistant individual.