Diabetes, Sport und Bewegung

ZUSAMMENFASSUNG

Bewegung ist für alle Formen des Diabetes mellitus eine der wichtigsten Maßnahmen, die Gesundheit zu erhalten. Regelmäßige körperliche Aktivität, möglichst uniform und täglich, kann vergleichbare Stoffwechseleffekte induzieren und somit die Glukoseregulation langfristig optimieren. Dabei ist die konkrete Blutzuckerantwort jedes Einzelnen abhängig von vielen Faktoren und muss bei Neubeginn von sportlicher Aktivität durch regelmäßige Blutzuckermessungen sowohl während als auch bis zu 12 h nach der Aktivität erfasst werden. Um bei älteren Menschen Erfolg zu haben, müssen Bewegungsprogramme deren körperliche Fähigkeiten, altersbedingten Leistungsabbau und krankheitsbedingte Beeinträchtigungen berücksichtigen. Die Nutzung von Geräten zur kontinuierlichen Glukosemessung (CGM) mit und ohne Insulinpumpentherapie hat viele Patienten in die Lage versetzt, die metabolische Kontrolle bei Bewegung und Sport besser zu überwachen, zu kontrollieren und zu optimieren. Die individuelle Blutzuckerreaktion auf verschiedene körperliche Belastungen ist mittels CGM leichter erlernbar, und Hypoglykämien sind früher vorhersag- und behandelbar. Ausdauerorientierte Bewegungsprogramme sollen primär die aerobe Kapazität steigern und sind aufgrund der positiven metabolischen und kardiopulmonalen Effekte eine gute Trainingsart. Auch ein Krafttraining für die großen Muskelgruppen kann (zusätzlich) empfohlen werden, da die Kraftbelastungen zu einer Zunahme der Muskel- und somit fettfreien Masse führen, resultierend in einer verbesserten Insulinresistenz. Zusätzlich sollte die Alltagsaktivität (Treppensteigen, Spazierengehen, Gartenarbeit etc.) gesteigert werden.

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