Körperliche Aktivität und Sport bei Typ-2-Diabetes Physical Activity and Sports in Patients With Type 2 Diabetes

A sufficient amount of physical activity is an important tool to prevent and treat type 2 diabetes. Beside an improvement in glycemic control, beneficial effects of physical activity and exercise training include a reduction of the cardiovascular risk profile, body weight and ectopic fat stores, anti-inflammatory properties and also an increase of physical fitness. In this context, exercise training lowers all-cause and cardiac mortality in type 2 diabetes. Actual recommendations reflect that adults with type 2 diabetes should be advised to perform at least 150min per week of moderate intensive aerobic exercise training (50 – 70% maximum heart rate). The training activity should be spread over at least three sessions during a week, and resting periods between the sessions should not exceed two days. In addition, in the absence of contraindications, adults with type 2 diabetes should be encouraged to perform resistance training at a minimum of twice a week. Moreover, a reduction of sedentary time by breaking up periods of sitting longer than 90 minutes should be realized. Risks during exercise training can arise from a non-optimal glycemic control. Moreover, long-term complications of diabetes such a retinopathy, autonomic neuropathy and coronary heart disease may lower tolerance to exercise. Thus, a pretraining evaluation and clinical judgement should be performed. If necessary, the training regimen has to be adapted to the individual case. To avoid hypoglycemia in patients treated with insulin or secretagogues, the medication dose has to be adapted individually and/or additional carbohydrates supplemented, if pre-exercise plasma glucose is measured below 100mg/dl.