Exercise Strategies to Prevent Hypoglycemia in Patients with Diabetes
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The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.
Abstract
The importance of adopting healthy exercise routines has been repeatedly emphasized to individuals with diabetes mellitus (DM). However, knowledge about the risk of exercise-induced hypoglycemia is limited. Regular exercise reduces and delays the onset of DM-related complications particularly in individuals who already have DM. However, an excessive exercise can lead to hypoglycemia. Excessive exercise in the evening can cause hypoglycemia while sleeping. Furthermore, if individuals with DM want to have a greater amount of exercise, the exercise duration rather than intensity must be increased. In weight resistance exercises, it is beneficial to first increase the number of repetitions, followed by the number of sets and gradually the weight of resistance. When performing intermittent high-intensity training within a short time period, hypoglycemia may develop for an extended period after exercise. In addition to adjusting exercise regimens, the medication doses must be modified accordingly. Delaying exercise, adjusting the number of snacks consumed prior to exercise, reducing insulin dose before exercise, and injecting insulin into the abdomen rather than the limbs prevent exercise-induced hypoglycemia prior to a spontaneous exercise. Ultimately, with personal knowledge on how to prevent hypoglycemia, the effects of exercise can be maximized in individuals with DM, and a healthy lifestyle can prevent future complications.
참고문헌 (25)
- Desouza CV, "Fonseca V. Hypoglycemia, diabetes, and cardiovascular events", Diabetes Care, 33, pp.1389~1394 (2010)
- ADVANCE Collaborative Group, "Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes", N Engl J Med, 358, pp.2560~2572 (2008)
- Cryer PE, "Death during intensive glycemic therapy of diabetes: mechanisms and implications", Am J Med, 124, pp.993~996 (2011)
- Cryer PE, "The barrier of hypoglycemia in diabetes", Diabetes, 2008(57), pp.3169~3176 (2008)
- Palmer SC, "Comparison of clinical outcomes and adverse events associated with glucose-lowering drugs in patients with type 2 diabetes: a metaanalysis", JAMA, 316, pp.313~324 (2016)
- Ben-Ami H, "Drug-induced hypoglycemic coma in 102 diabetic patients", Arch Intern Med, 159, pp.281~284 (1999)
- Kemi OJ, "Moderate vs. high exercise intensity: differential effects on aerobic fitness, cardiomyocyte contractility, and endothelial function", Cardiovasc Res, 67, pp.161~172 (2005)
- Chen CN, "Clinical measures of physical fitness predict insulin resistance in people at risk for diabetes", Phys Ther, 88, pp.1355~1364 (2008)
- Shahar J, "Medication and exercise interactions: considering and managing hypoglycemia risk", Diabetes Spectr, 28, pp.64~67 (2015)
- Ibanez J, "Twice-weekly progressive resistance training decreases abdominal fat and improves insulin sensitivity in older men with type 2diabetes", Diabetes Care, 28, pp.662~667 (2005)
- Asano RY, "Acute effects of physical exercise in type 2 diabetes: a review", World J Diabetes, 5, pp.659~665 (2014)
- Wang Y, "Adaptations to exercise training within skeletal muscle in adults with type 2 diabetes or impaired glucose tolerance: a systematic review", Diabetes Metab Res Rev, 25, pp.13~40 (2009)
- Minuk HL, "Glucoregulatory and metabolic response to exercise in obese noninsulin-dependent diabetes", Am J Physiol, 240, pp.E458~E464 (1981)
- Cade WT, "Hypoglycemia during moderate intensity exercise reduces counterregulatory responses to subsequent hypoglycemia", Physiol Rep, 4, pp.e12848~ (2016)
- Davis SN, "Mechanisms of hypoglycemia and exercise-associated autonomic dysfunction", Trans Am Clin Climatol Assoc, 125, pp.281~291 (2014)
- Younk LM, "Exercise-related hypoglycemia in diabetes mellitus", Expert Rev Endocrinol Metab, 6, pp.93~108 (2011)
- Miller CD, "Hypoglycemia in patients with type 2 diabetes mellitus", Arch Intern Med, 161, pp.1653~1659 (2001)
- Boule NG, "Effects of exercise training on glucose homeostasis: the HERITAGE Family Study", Diabetes Care, 28, pp.108~114 (2005)
- Colberg SR, "Physical activity", exercise and diabetes: a position statement of the American Diabetes Association, 2016, pp.39, 2065~2079
- Rabasa-Lhoret R, "Guidelines for premeal insulin dose reduction for postprandial exercise of different intensities and durations in type 1 diabetic subjects treated intensively with a basal-bolus insulin regimen (ultralente-lispro)", Diabetes Care, 24, pp.625~630 (2001)
- Yon Su Kim, "Frequency and Severity of Hypoglycemia in Type 2 Diabetes Mellitus Patients Treated with a Sulfonylurea-Based Regimen at University-Affiliated Hospitals in Korea: The Naturalistic Evaluation of Hypoglycemic Events in Diabetic Subjects Study", Korean Journal of Family Medicine, 40(4), pp.212~219 (2019), 대한가정의학회[DOI]
- Yun Jun Yang, "An Overview of Current Physical Activity Recommendations in Primary Care", Korean Journal of Family Medicine, 40(3), pp.135~142 (2019), 대한가정의학회[DOI]
- Zaharieva DP, "Prevention of exercise-associated dysglycemia: a case study-based approach", Diabetes Spectr, 28, pp.55~62 (2015)
- 박성근, "한국인에 있어서 Insulin Resistance의 계절적 변동성", Korean Circulation Journal, 35(8), pp.620~624 (2005), 대한심장학회
- Yki-Jarvinen H, "Ethanol decreases glucose utilization in healthy man", J Clin Endocrinol Metab, 61, pp.941~945 (1985)