Typ-1-Diabetes und Sport

ZUSAMMENFASSUNG

Sport verbessert die körperliche Fitness, beugt Herz-Kreislauf-Erkrankungen vor und steigert das psychische Wohlbefinden. Eine der größten Herausforderungen im Alltag von Menschen mit Typ-1-Diabetes ist es, den Glukosespiegel vor, während und nach dem Sport im physiologischen Bereich zu halten. In diesem Beitrag beschreiben wir, durch welche gezielten Maßnahmen Menschen mit Typ-1-Diabetes ihr Glukosemanagement bei Sport verbessern können.

Publication History

Article published online:
15 February 2024

• Literatur

• 1 Roep BO, Thomaidou S, van Tienhoven R. et al Type 1 diabetes mellitus as a disease of the β-cell (do not blame the immune system?). Nat Rev Endocrinol 2021; 17: 150-161 DOI: 10.1038/s41574-020-00443-4.
• 2 Danne T, Nimri R, Battelino T. et al International consensus on use of continuous glucose monitoring. Diabetes Care 2017; 40: 1631-1640 DOI: 10.2337/dc17-1600.
• 3 Sylow L, Kleinert M, Richter EA. et al Exercise-stimulated glucose uptake – regulation and implications for glycaemic control. Nat Rev Endocrinol 2017; 13: 133-148 DOI: 10.1038/nrendo.2016.162.
• 4 Lascar N, Kennedy A, Hancock B. et al Attitudes and barriers to exercise in adults with type 1 diabetes (T1DM) and how best to address them: a qualitative study. PLoS One 2014; 09: e108019 DOI: 10.1371/journal.pone.0108019.
• 5 Jayawardene DC, McAuley SA, Horsburgh JC. et al Closed-Loop Insulin Delivery for Adults with Type 1 Diabetes Undertaking High-Intensity Interval Exercise Versus Moderate-Intensity Exercise: A Randomized, Crossover Study. Diabetes Technol Ther 2017; 19: 340-348 DOI: 10.1089/dia.2016.0461.
• 6 Pitt JP, McCarthy OM, Hoeg-Jensen T. et al Factors influencing insulin absorption around exercise in type 1 diabetes. Front Endocrinol (Lausanne) 2020; 11: 573275 DOI: 10.3389/fendo. 2020.573275.
• 7 Moser O, Tschakert G, Mueller A. et al Effects of high-intensity interval exercise versus moderate continuous exercise on glucose homeostasis and hormone response in patients with type 1 diabetes mellitus using novel ultra-long-acting insulin. PLoS One 2015; 10: e0136489 DOI: 10.1371/journal.pone.0136489.
• 8 Riddell MC, Gallen IW, Smart CE. et al Exercise management in type 1 diabetes: a consensus statement. Lancet Diabetes Endocrinol 2017; 05: 377-390 DOI: 10.1016/s2213-8587(17)30014-1.
• 9 Moser O, Riddell MC, Eckstein ML. et al Glucose management for exercise using continuous glucose monitoring (CGM) and intermittently scanned CGM (isCGM) systems in type 1 diabetes: position statement of the European Association for the Study of Diabetes (EASD) and of the International Society for Pediatric and Adolescent Diabetes (ISPAD) endorsed by JDRF and supported by the American Diabetes Association (ADA). Diabetologia 2020; 63: 2501-2520 DOI: 10.1007/s00125-020-05263-9.
• 10 Riddell MC, Peters AL. Exercise in adults with type 1 diabetes mellitus. Nat Rev Endocrinol 2023; 19: 98-111 DOI: 10.1038/s41574-022-00756-6.
• 11 Yardley JE. Reassessing the evidence: prandial state dictates glycaemic responses to exercise in individuals with type 1 diabetes to a greater extent than intensity. Diabetologia 2022; 65: 1994-1999 DOI: 10.1007/s00125-022-05781-8.
• 12 Toghi-Eshghi SR, Yardley JE. morning (fasting) vs afternoon resistance exercise in individuals with type 1 diabetes: A randomized crossover study. J Clin Endocrinol Metab 2019; 104: 5217-5224 DOI: 10.1210/jc.2018-02384.
• 13 Murillo S, Brugnara L, Servitja JM. et al High intensity interval training reduces hypoglycemic events compared with continuous aerobic training in individuals with type 1 diabetes: HIIT and hypoglycemia in type 1 diabetes. Diabetes Metab 2022; 48: 101361 DOI: 10.1016/j.diabet.2022.101361.
• 14 Chimen M, Kennedy A, Nirantharakumar K. et al What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia 2012; 55: 542-551 DOI: 10.1007/s00125-011-2403-2.
• 15 Gal JJ, Li Z, Willi SM. et al Association between high levels of physical activity and improved glucose control on active days in youth with type 1 diabetes. Pediatr Diabetes 2022; 23: 1057-1063 DOI: 10.1111/pedi.13391.
• 16 Kennedy A, Nirantharakumar K, Chimen M. et al Does exercise improve glycaemic control in type 1 diabetes? A systematic review and meta-analysis. PLoS One 2013; 08: e58861 DOI: 10.1371/journal.pone.0058861.
• 17 Adolfsson P, Riddell MC, Taplin CE. et al ISPAD Clinical Practice Consensus Guidelines 2018: Exercise in children and adolescents with diabetes. Pediatr Diabetes 2018; 19: 205-226 DOI: 10.1111/pedi.12755.
• 18 Colberg SR, Sigal RJ, Yardley JE. et al Physical activity/exercise and diabetes: a position statement of the American Diabetes Association. Diabetes Care 2016; 39: 2065-2079 DOI: 10.2337/dc16-1728.
• 19 Moser O, Müller A, Aberer F. et al Comparison of insulin glargine 300 u/ml and insulin degludec 100 u/ml around spontaneous exercise sessions in adults with type 1 diabetes: a randomized cross-over trial (ULTRAFLEXI-1 Study). Diabetes Technol Ther 2023 DOI: 10.1089/dia.2022.0422
• 20 MacDonald MJ. Postexercise late-onset hypoglycemia in insulindependent diabetic patients. Diabetes Care 1987; 10: 584-588 DOI: 10.2337/diacare.10.5.584.