Diabetes and physical training

Schulze A2 , Busse M1

General Outpatient Ambulance1 and Sports Dentistry2 of the Institute of Sports Medicine, University of Leipzig (1Director: Prof. M.W. Busse, MD) (2Head: A. Schulze, DDS)

Summary

Schulze A, Busse M . Diabetes and physical training. Clinical Sports Medicine International (CSMI) 2009, 1(3): 11-13. Increased physical activity improves insulin sensitivity and glucose metabolism, independent of diabetes and obesity.
Physical exercise is an important adjunct in the diabetes therapy. Similar to insulin, physical exercise increases the rate of glucose uptake into the contracting skeletal muscles, regulated by the translocation of GLUT4 glucose transporters to the plasma membrane and transverse tubules. Regular endurance training for elderly and diabetics has its peak cardio-pulmonary efficiency at approximately 50% of the maximum performance levels. This corresponds to a training session of at least 60 minutes. On a short-term basis, a 50% reduction of daytime and 30% reduction of night time insulin demand is to be expected, given a long training session (upwards of an hour). Oral anti diabetics (OAD) can be compensated through glucose after periods of physical strain, whereby the starting value of glucose levels should be monitored as well. Exercise training results in an increase in GLUT4 expression. So it has a beneficial effect on insulin sensitivity. Consistent training over time also achieves medium-term effects and reduces hepatic glucose production. However a 14-day interruption of training is enough to reverse the positive effects.

Key words: diabetes, physical training, insulin sensitivity, metabolic regulation, endurance training intensity