Körperliche Aktivität und Trainingstherapie bei Typ-2-Diabetes – ein Update

Regelmäßige körperliche Aktivität und Training besitzen bei Menschen mit Typ-2-Diabetes ein breites Wirkspektrum. Günstige Effekte auf die glykämische Stoffwechsellage sind ebenso nachgewiesen wie die Absenkung des aufgrund der Erkrankung erhöhten kardiovaskulären Risikos. Die Empfehlung zu regelmäßiger körperlicher Aktivität bei Patienten mit Typ-2-Diabetes ist in den Leitlinien abgebildet und sollte bei der Betreuung der Betroffenen Beachtung finden.

Abstract

Regular physical activity and training are important tools in the therapy of type 2 diabetes and exert a broad spectrum of beneficial effects. These include an improvement in glycemic control, a decrease of body fat and ectopic fat stores, a lowering effect on blood pressure as well as on cholesterol and triglycerides levels, anti-inflammatory properties and an increase and stabilization of physical fitness. As a result, exercise/training are sufficient to lower all-cause and cardiac mortality in patients with type 2 diabetes.

The actual guidelines on exercise therapy for type 2 diabetes recommend aerobic endurance training and strength training as the two main components. Patients should be instructed to perform a minimum volume of 150 min of moderate-intense aerobic endurance training and additional 2–3 sessions of resistance training per week. In addition, additional recommendations include to train flexibility and balance, to avoid prolonged periods of permanent sitting, and to use activities of daily living to enhance physical exercise times.

Importantly, patients with type 2 diabetes should consider possible risks of exercise, which may arise from existing diabetes-related complications such as retinopathy, peripheral and autonomic neuropathy, but also coronary heart disease. Thus, the individual exercise tolerance has to be clarified and, if necessary, the training program should be adapted. Patients who receive insulin or secretagoga, exercise-induced hypoglycaemia should be prevented by reducing the dosage of the medication and/or administering additional carbohydrates on an individual basis.

Schlüsselwörter

Typ-2-Diabetes - Ausdauertraining - Intervalltraining - Krafttraining - glykämische Kontrolle - kardiometaboles Risiko

Keywords

type-2-diabetes - aerobic exercise training - resistance training - interval training - glycemic control - cardiometabolic risk

Publication History

Article published online:
06 February 2024

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