Diabetes and Exercise

Exercise participation often stimulates diabetic patients to comply with proper diabetic management, and it may help get diabetics involved in self-education about their disease.     

Exercise and type 2 diabetes: American College of Sports Medicine and the American Diabetes Association: joint position statement. Exercise and type 2 diabetes

Although physical activity (PA) is a key element in the prevention and management of type 2 diabetes mellitus (T2DM), many with this chronic disease do not become or remain regularly active. High-quality studies establishing the importance of exercise and fitness in diabetes were lacking until recently, but it is now well established that participation in regular PA improves blood glucose control and can prevent or delay T2DM, along with positively affecting lipids, blood pressure, cardiovascular events, mortality, and quality of life. Structured interventions combining PA and modest weight loss have been shown to lower T2DM risk by up to 58% in high-risk populations. Most benefits of PA on diabetes management are realized through acute and chronic improvements in insulin action, accomplished with both aerobic and resistance training. The benefits of physical training are discussed, along with recommendations for varying activities, PA-associated blood glucose management, diabetes prevention, gestational diabetes, and safe and effective practices for PA with diabetes-related complications.     

Competitive Sports for Children of Elementary

Athletic performances have improved at an astonishing rate over the past several decades. Times have dropped, and standards of excellence have improved. Increased work loads, better nutrition, and advanced medical care are some of the reasons athletes are better than ever.     

Exercise and Osteoporosis-Related Fractures: Perspectives and Recommendations of the Sports and Exercise Scientist

Abstract

Osteoporosis-related fractures represent a major health concern, particularly in elderly populations. Direct and indirect costs (amounting to nearly $17 billion in 2005), increased morbidity, and loss of independence place substantial burden on the health care system. Observational studies have shown that a physically active lifestyle is associated with a 30% to 50% decrease in vertebral or hip fractures, and a recent meta-analysis that determined the effects of exercise on fracture incidence further confirmed these results. However, because no randomized controlled exercise trials have selected fractures as a primary endpoint, causality between a sedentary lifestyle and fractures may be potentially confounded by participants' poor health status. With regard to fall reduction and bone strength as the main surrogates for fracture risk, many randomized controlled trials and corresponding meta-analyses have reported significant positive outcomes. Interestingly, no study that has assessed fall-related injuries has focused specifically on interventions that aimed to reduce fall impact. There is ongoing debate as to which factor, osteoporosis or falls, is more important for fracture prevention. This may be dependent on the region prone to fracture and the subjects' health status. In randomized controlled trials on exercise, the type, mode, and composition of exercise parameters are predictors of study outcome. Unfortunately, many exercise trials on fall prevention have not adequately described the exercise protocol used, which makes it difficult to determine which fall prevention protocol was most effective. A recent meta-analysis recommended Tai Chi and/or a mix of balance and resistance exercises for fall prevention. More sophisticated protocols are required to impact bone strength. Corresponding state-of-the-art protocols have focused on periodized high-impact/high-intensity resistance protocols performed at least twice per week. In the frail elderly, high-frequency/high-cycle number exercise programs with low-to-moderate strain intensity may also positively affect bone strength.     

The Role of Exercise in Managing Diabetes

Approximately 11 million Americans have diabetes mellitus, which with its complications is the third-leading cause of death by disease in the United States. Exercise is particularly important in managing diabetes.     

Stroking Parameters during Continuous and Intermittent Exercise in Regional-Level Competitive Swimmers

This study aimed to determine whether maximal lactate steady state (MLSS) represents a boundary above which not only physiological but also technical changes occur. On different days, 13 male swimmers (23±9 years) performed the following tests: 1) a 400-m all-out swim, to determine maximal aerobic speed (S-400); 2) a series of 30-min sub-maximal swims, to determine continuous MLSS (MLSSc), and; 3) a series of 12×150 s sub-maximal swims, to determine intermittent MLSS (MLSSi). Stroke rate (SR), distance per stroke cycle (DS) and stroke index (SI) were analyzed at and above (102.5%) MLSSc and MLSSi. MLSSi (1.17±0.09 m.s - 1) was significantly higher than MLSSc (1.13±0.08 m.s - 1) while blood lactate concentration (mmol.L - 1) was similar between the 2 conditions (4.3±1.1 and 4.4±1.5, respectively). The increase in SR and decreases in DS and SI were significant during MLSSi, 102.5% MLSSc and 102.5% MLSSi. During MLSSc, DS also decreased significantly (- 3.6%) but with no change in SR or SI. Thus, stroking technique of regional-level competitive swimmers changes over time when they swim at or above MLSS. This is the case during both continuous and intermittent swimming, despite steady state blood lactate concentrations.     

不同运动因素对2型糖尿病患者早餐后糖代谢的影响

目的:观察不同步行强度、起始和持续时间对2型糖尿病患者餐后血糖与胰岛素水平的影响。方法:12名2型糖尿病患者进行每次间隔1周的1次静息和4次运动实验,测定空腹及标准早餐后各时点的血糖及胰岛素;采用三因素两水平正交设计,混合模型分析。结果:运动可显著降低2型糖尿病患者餐后峰值血糖和血糖曲线下面积(GlucoseAreaUndertheserumconcentrationCurve,GAUC),但对胰岛素曲线下面积(InsulinAreaUndertheserumconcentrationCurve,IAUC)影响不显著(P>0·05),其中运动强度为3·3代谢当量(MetabolicEquivalentsMETs)、持续时间40min、血糖峰值前30min运动的峰值血糖显著低于静息值(P<0·05);糖尿病史>5年组和BMI>26组运动实验峰值血糖和GAUC显著降低(P<0·05)。结论:单次步行可显著降低2型糖尿病患者餐后峰值血糖和GAUC,但对IAUC影响不明显;糖尿病病史长、体形肥胖的患者运动降糖效果更显著。     

太极拳锻炼对2型糖尿病的疗效观察及其机制探讨

目的 :观察太极拳锻炼对 2型糖尿病人的疗效 ,并对其机制进行探讨。方法 :1 2例老年2型糖尿病患者进行为期 8周的太极拳锻炼 ,观察锻炼前和锻炼后空腹、锻炼 8周结束时一次性运动前和运动后即刻空腹血糖 (glucose)、血浆胰岛素 (Ins)及红细胞胰岛素受体 (InR)等指标的变化。血糖、胰岛素的测定用临床常规检验法 ,红细胞胰岛素受体用改良Gambhir法。结果 :(1 )经过 8周锻炼后 ,糖尿病人安静状态下前后对比 :血糖水平降低(P <0 0 5 ) ,Ins水平未见显著变化 ,低亲和力胰岛素受体数目 (r2 )及低亲和力胰岛素受体结合容量 (R2 )增加 (P <0 0 5 )。 (2 )锻炼 8周结束时 ,一次性运动后即刻与运动前安静状态下比较 :血糖、高、低胰岛素受体数目 (r1、r2 )和高、低胰岛素受体结合容量(R1、R2 )均升高 (P <0 0 5 ) ,而胰岛素水平未见显著变化。结论 :(1 )长期太极拳锻炼在维持糖尿病患者正常的胰岛素分泌水平的基础上 ,能有效降低血糖水平 ;(2 )胰岛素受体活性的增加可能是太极拳运动对 2型糖尿病产生疗效的一种机制     

American College of Sports Medicine position stand. Exercise and fluid replacement

This Position Stand provides guidance on fluid replacement to sustain appropriate hydration of individuals performing physical activity. The goal of prehydrating is to start the activity euhydrated and with normal plasma electrolyte levels. Prehydrating with beverages, in addition to normal meals and fluid intake, should be initiated when needed at least several hours before the activity to enable fluid absorption and allow urine output to return to normal levels. The goal of drinking during exercise is to prevent excessive (>2% body weight loss from water deficit) dehydration and excessive changes in electrolyte balance to avert compromised performance. Because there is considerable variability in sweating rates and sweat electrolyte content between individuals, customized fluid replacement programs are recommended. Individual sweat rates can be estimated by measuring body weight before and after exercise. During exercise, consuming beverages containing electrolytes and carbohydrates can provide benefits over water alone under certain circumstances. After exercise, the goal is to replace any fluid electrolyte deficit. The speed with which rehydration is needed and the magnitude of fluid electrolyte deficits will determine if an aggressive replacement program is merited.