Diyabet ve egzersiz

Fizik aktivitenin azalması ve obezitenin artması ile tip 2 diyabet yaygınlığı da artmaktadır. Egzersiz, plazma glukozunu ve HbA1C’yi düşürür, bazal ve postprandiyal insulin seviyelerini azaltır, insulin duyarlılığını arttırır, lipid profilini düzeltir. Ayrıca, bozulmuş glukoz toleransı olanlarda aşikar diyabete ilerlemeyi yavaşlatır. Diyabetik hastalara haftada en az 150 dakikalık orta dereceli aerobik egzersiz önerilir. Hastalar, haftada 3-4 kez, 30-60 dakikalık egzersizler ile aktiviteye özendirilmelidirler.

Diabetes and exercise

The incidence of type 2 diabetes mellitus increases with the decrease in physical activity and increase in obesity. Exercise decreases plasma glucose, HbA1C, basal and postprandial insulin levels; increases insulin sensitivity and improves lipid profile. It also slows down progress into type 2 diabetes mellitus those with impaired glucose tolerance. At least 150 minutes of moderate aerobic exercise per week is recommended to diabetic patients. Patients should be encouraged for activity for 30-60 minutes of exercises 3-4 times a week.

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  • ACOG Committee Opinion, 2001. Exercise during pregnancy and the postpartum period. Obstet. Gynecol. 99, 171–173.
  • Aljasir, B., Bryson, M., Al-Shehri, B., 2008. Yoga practice for the management of type II diabetes mellitus in adults: a systematic review. Evid Based Complement Altern Med. Electronically published ahead of print (doi:10.1093/ecam/nen027).
  • American Diabetes Association, 2011. Diabetes Care, Vol 34, Supplement 1, January, pp:24-25.Artal, R., 1990. Exercise and diabetes mellitus in pregnancy: A brief review. Sports. Med. 9, 261–265.
  • Aubert, R.E., Herman, W.H., Waters, J., Moore, W., Sutton, D., Peterson, B.L., Bailey, C.M., Koplan, J.P., 1998. Nurse case management to improve glycemic control in diabetic patients in a health maintenance organization: A randomized, controlled trial. Ann. Intern. Med. 129, 605–612.
  • Boule, N.G., Kenny, G.P., Haddad, E., Wells, G.A., Sigal, R.J., 2003. Meta-analysis of the effect of structured exercise training on cardiorespira- tory fitness in type 2 diabetes mellitus. Diabetologia. 46, 1071–1081.
  • Brown, M.D., Moore, G.E., Korytkowski, M.T., McCole, S.D., Hagberg, J.M., 1997. Improvement of insulin sensitivity by short-term exercise training in hypertensive African American women. Hypertension. 30, 1549–1553.
  • Castaneda, C., Layne, J.E., Munoz-Orians, L., Gordon, P.L., Walsmith, J., Foldvari, M., Roubenoff, R., Tucker, K.L., Nelson, M.E., 2002. A randomized controlled trial of resistance exercise training to improve glycemic control in older adults with type 2 diabetes. Diabetes Care. 25, 2335–2341.
  • Catherine, A., Mullooly, M.S., Karen, L., Kemmis, P.T., 2005. Diabetes Educators and the Exercise Prescription. Diabetes Spectrum. 18, 108- 113.
  • David, C., Wright, M.S., Pamela, D.S., 2001. Optimal exercise intensity for individuals with impaired glucose tolerance. Diabetes Spectrum. 18, 93-97.
  • Dela, F., von Linstow, M.E., Mikines, K.J., Galbo, H. , 2004 . Physical training may enhance beta-cell function in type 2 diabetes. Am. J. Physiol. Endocrinol. Metab. 287, 1024-1031.
  • Douen, A.G., Ramlal, T., Cartee, G.D., Klip, A., 1990. Exercise modulates the insulin-induced translocatio of glucose transporters in rat skeletal muscle. FEBS. Lett. 261, 256–260.
  • George, D., Harris, M.D., Russell, D.W., 2005. Diabetes management and exercise in pregnant patients with diabetes. Clin. Diabetes. 23, 165- 168.
  • Grebe, S.K.G., Smith, R.B.W., 1995. Clinical audit and standardized follow-up improve quality of documentation in diabetes care. N. Z. Med. J. 108, 339–342.
  • Gulve, E.A., 2008. Exercise and glycemic control in diabetes: Benefits, challenges, and adjustments to pharmacotherapy. Phys. Ther. 88, 1297– 1321.
  • Harris, G.D., 2005. Exercise and the pregnant patient: A clinical overview. Women Health Primary Care. 8, 79–86.
  • Innes, K.E., Bourguignon, C., Taylor, A.G., 2005. Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and pos- sible protection with yoga: A systematic review. J. Am. Board. Fam. Pract. 18, 491–519.
  • Ivy, J.L., Zderic, T.W., Fogt, D.L., 1999. Prevention and treatment of non-insulin-dependent diabetes mellitus. Exerc. Sport. Sci. Rev. 27, 1–35.
  • King, D.S., Baldus, P.J., Sharp, R., Kesl, L.D., Feltmeyer, T.L., Riddle, M.S., 1995. Time course for exercise induced alterations in insulin ac- tion and glucose tolerance in middle-aged people. J. Appl. Physiol. 78, 17–22.
  • King, D.S., Feltmeyer, T.L., Baldus, P.J., Sharp, R.L., Nespor, J., 1993. Effects of eccentric exercise on insulin secretion and action in humans. J. Appl. Physiol. 75, 2151–2156.
  • Knight K, Badamgarav E, Henning JM, Hasselblad V, Gano AD Jr, Ofman JJ, Weingarten SR: A systematic review of diabetes disease manage- ment programs. Am J Managed Care 11:242–50, 2005.
  • Knowler, W.C., Barrett-Connor, E., Fowler, S.E., Hamman, R.F., Lachin, J.M., Walker, E.A., Nathan, D.M., 2002. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393-403.
  • Konca, L., Ayvaz, G., 2011. Tip 2 diyabetes mellitusun insulin dışı tedavisi. Endokrinoloji Metabolizma ve Diyabet, 2.baskı, Metin Özata, ed. İstanbul Tıp Kitabevi Yayıncılık, İstanbul, pp. 572-582.
  • Lan, C., Chen, S.Y., Lai, J.S., 2008. The exercise intensity of tai chi chuan. Med. Sport. Sci. 52, 12–19.
  • Metzger, B.E., Coustan, D.M., 1998. Organizing Committee. Summary and recommendations of the fourth international workshop-conference on gestational diabetes mellitus. Diabetes Care. 21, B161–B167.
  • Mitchell, T.H., Abraham, G., Schiffrin, A., Leiter, L.A., Marliss, E.B., 1988. Hyperglycemia after intense exercise in IDDM subjects during continuous subcutaneous insulin infusion. Diabetes Care. 11, 311-317.
  • Mogensen, C.E., 2002. Nephropathy. In Handbook of Exercise in Diabetes. 2nd ed. Ruderman, N., Devlin, J.T., Kriska, A., Alexandria, V.A., American Diabetes Association, p. 433–449.
  • Monro, R., Power, J., Coumar, A., Dandona, P., 1992. Yoga therapy for NIDDM: A control trial. Complement Med. Res. 6, 66–68.
  • Nelson, M.E., Rejeski, W.J., Blair, S.N., Duncan, P.W., Judge, J.O., King, A.C., Macera, C.A., Castaneda-Sceppa, C., 2007. Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association. Med. Sci. Sports. Exerc. 39, 1435–1445.
  • Pariser, G., Ann, D,M., Gillette, P., Stephen, W., 2010. Outcomes of an education and exercise program for adults with Type 2 diabetes, and comorbidities that limit their mobility: A Preliminary Project Report. Cardiopulm Phys. Ther. J. 21, 5-12.
  • Peyrot, M., Rubin, R.R., Lauritzen, T., Snoek, F.J., Matthews, D.R., Skovlund, S.E., 2005. Psychosocial problems and barriers to improved dia- betes management: results of the cross-national Diabetes Attitudes, Wishes, and Needs study. Diabet. Med. 22, 1379– 1385.
  • Richter, E.A., Galbo, H., 2004. Diabetes and exercise. Int. Diabetes. Monitor. 16, 1–9.
  • Rogers, M.A.,Yamamoto, C., King, D.S., Hagberg, J.M., Ehsani, A.A., Holloszy, J.O., 1988. Improvement in glucose tolerance after 1 week of exercise in patients with mild NIDDM. Diabetes Care. 11, 613–618.
  • Schell, T.C., Wright, G., Martino, P., Ryder, J., Craig, B.W., 1999. Post-exercise glucose, insulin, and C-peptide responses to carbohydrate sup- plementation: Running vs. resistance exercise. J. Strgth. Cond. Res. 13, 372–380.
  • Schriger, D.L., Baraff, L.J., Rogers, W.H., Cretin, S., 1997. Implementation of clinical guidelines using a computer charting system: Effect on the initial care of health care workers exposed to body fluids. JAMA. 278, 1585–1590.
  • Setji, T.L., Brown, A.J., Feinglos, M.N., 2005. Gestational diabetes mellitus. Clin. Diabetes. 23, 17–24.
  • Sherman, W.M., Lash, J.M., Simonsen, J.C., Bloomfield, S.A., 1992. Effects of downhill running on the responses to an oral glucose challenge. Int. J. Sport. Nutr. 3, 251–259.
  • Sigal, R.J., Kenny, G.P., Boule, N.G., Wells, G.A., Prud’homme, D., Fortier, M., Reid, R.D., Tulloch, H., Coyle, D., Phillips, P., Jennings, A., Jaffey, J., 2007. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: Arandomized trial. Ann. Intern. Med. 147, 357–369.
  • Snowling, N.J., Hopkins, W.G., 2006. Effects of different modes of exercise training on glucose control and risk factors for complications in type 2 diabetic patients: a meta-analysis. Diabetes Care. 29, 2518–2527.
  • Steppel, J.H., Horton, E.S., 2008. Diyabetes mellituslu hastalarda egzersiz. Joslin’s Diabetes Mellitus, 14. baskı, Khan, C.R., Weir, G.C., King, G.L., Jacobson, A.M., Moses, A.C., Smith, R.C., eds. Istanbul Medikal Yayıncılık, İstanbul, pp. 649-656.
  • Thomas, D.E., Elliott, E.J., Naughton, G.A., 2009. Exercise for type 2 diabetes mellitus. The Cochrane Library. issue 1, 1-55.
  • Tuomilehto, J., Lindstrom, J., Eriksson, J.G., Valle. T.T., Hamalainen, H., Illanne-Parikka, P., Keinanen-Kiukaaniemi, S., Laakso, M., Louher- anta, A., Rastas, M., Salminen, V., Uusitupa, M., 2001. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N. Engl. J. Med. 344, 1343–1350.
  • Wang, J.H. , 2008. Effects of tai chi exercise on patients with type 2 diabetes. Med. Sport. Sci. 52, 230–238.
  • Wojtaszewski, J.F., Nielsen, J.N., Richter, E.A., 2002. Invited review: Effect of acute exercise on insulin signaling and action in humans. J. Appl. Physiol. 93, 384–392.
  • Wood, D.J., Rumsby, M.G., Warr, J.R., 1996. Monensin and verapamil do not alter intracellular localisation of daunorubicin in multidrug resis- tant human KB cells. Cancer Lett. 108, 41-47.
  • World Cancer Report, 2003. International Agency for Research on Cancer.
  • Xin, L., Miller, Y.D., Brown, W.J., 2007. A qualitative review of the role of qigong in the management of diabetes. J. Altern. Complement. Med. 13, 427–433.
  • Yecies, J.L., Manning, B.D., 2011. mTOR links oncogenic signaling to tumor cell metabolism. J. Mol. Med. 89, 221-228.
  • Yogendra, J., Yogendra, H.J., Ambardekar, S., Lele, R.D., Shetty, S., Dave, M., Husein, N., 2004. Beneficial effects of yoga lifestyle on revers- ibility of ischaemic heart disease: Caring Heart Project of the International Board of Yoga. J. Assoc. Physicians. India. 52, 283–289.
  • Zhang, Y., Fu, F.H., 2008. Effects of 14-week tai ji quan exercise on metabolic control in women with type 2 diabetes. Am. J. Chin. Med. 36, 647–654.
  • Zinman, B, Ruderman, N., Campaigne, B.N., Devlin, J.T., Schneider, S.H. 2004. Physical activity/exercise and diabetes. Diabetes Care. 27 Suppl 1, 58-62.