Drveejay11
Community Veteran
Exercise in Type II Diabetes Mellitus
Initial treatment of type II diabetes consists of weight reduction, dietary control, exercise, and oral hypoglycemic agents. Insulin replacement is seldom necessary but should be added to the treatment regimen when hyperglycemia remains unchecked by these methods. Exercise is a major contributor in controlling hyperglycemia through improved peripheral insulin sensitivity, enhanced insulin binding, and reduced obesity.
Exercise can aid glycemic control and in combination with proper diet help prevent type II diabetes from occurring in those persons at risk. Exercise does this by improving short-term insulin sensitivity and reducing insulin resistance, both of which begin to disappear a few days after exercise is discontinued. Althought the number of insulin receptors remains constant with exercise, the biding of insulin to adipocytes is increased with no increase noted in binding to myocytes. In both cell types, however, the number and activity of glucose transport proteins (particularly Glut-4-isoform) are increased with exercise. This results in an increase in insulin-stimulated glucose transport into these cells following exercise, which improves glycemic control.
With the onset of exercise, the type II patient, does not respont with a decrease in serum glucose concentration as in the nondiabetic. This is due to increased glucose uptake in the peripheral tissues. As a result, serum glucose is higher, and liver glucose production is halted to allow for normalization of the hyperglycemia by overall reduction in the glucose level. In constrast to the type I patient, type II diabetics do not usually suffer hypoglycemia because endogenous insulin levels can usually be maintained. Those athletes on oral hypoglycemic agents or insulin, however, may have problems with glucose homeostasis during exercise. The athlete may need to lower the medication dose or increase carbohydrate intake (or both) before exercise to prevent hypoglycemia. Severe hypoglycemia is unusual because individuals are still able to reduce endogenous insulin production as blood glucose levels decline.
Bibliography
1. Sports Medicine for Primary Care, Willian E. Moats
2. Goodman, The Pharmacological Basis of Therapheutics, Nineth Edition, Goodman & Gilman’s
3. The Medical Clinics of North America, Vol 78, Num 2 , Gray I. Wadler.
4. Cecil , Textbook of Medicine. twenth edition, Bennet & Plum
5. Exercise prescription fo Individuals with metabolic disorders (pratical considerations) John C. Young. SPORTS MED. 19(1) PAG 43 - 54 1995
Initial treatment of type II diabetes consists of weight reduction, dietary control, exercise, and oral hypoglycemic agents. Insulin replacement is seldom necessary but should be added to the treatment regimen when hyperglycemia remains unchecked by these methods. Exercise is a major contributor in controlling hyperglycemia through improved peripheral insulin sensitivity, enhanced insulin binding, and reduced obesity.
Exercise can aid glycemic control and in combination with proper diet help prevent type II diabetes from occurring in those persons at risk. Exercise does this by improving short-term insulin sensitivity and reducing insulin resistance, both of which begin to disappear a few days after exercise is discontinued. Althought the number of insulin receptors remains constant with exercise, the biding of insulin to adipocytes is increased with no increase noted in binding to myocytes. In both cell types, however, the number and activity of glucose transport proteins (particularly Glut-4-isoform) are increased with exercise. This results in an increase in insulin-stimulated glucose transport into these cells following exercise, which improves glycemic control.
With the onset of exercise, the type II patient, does not respont with a decrease in serum glucose concentration as in the nondiabetic. This is due to increased glucose uptake in the peripheral tissues. As a result, serum glucose is higher, and liver glucose production is halted to allow for normalization of the hyperglycemia by overall reduction in the glucose level. In constrast to the type I patient, type II diabetics do not usually suffer hypoglycemia because endogenous insulin levels can usually be maintained. Those athletes on oral hypoglycemic agents or insulin, however, may have problems with glucose homeostasis during exercise. The athlete may need to lower the medication dose or increase carbohydrate intake (or both) before exercise to prevent hypoglycemia. Severe hypoglycemia is unusual because individuals are still able to reduce endogenous insulin production as blood glucose levels decline.
Bibliography
1. Sports Medicine for Primary Care, Willian E. Moats
2. Goodman, The Pharmacological Basis of Therapheutics, Nineth Edition, Goodman & Gilman’s
3. The Medical Clinics of North America, Vol 78, Num 2 , Gray I. Wadler.
4. Cecil , Textbook of Medicine. twenth edition, Bennet & Plum
5. Exercise prescription fo Individuals with metabolic disorders (pratical considerations) John C. Young. SPORTS MED. 19(1) PAG 43 - 54 1995