TABLE 2: DIABETES MELLITUS TYPE 1 AND PHYSICAL ACTIVITY

Abstract

Regular physical exercise, in type 1 diabetes should provide cardiovascular protection and immunomodulatory properties, but the complex interaction between the effects of exercise on carbohydrate metabolism and exogenous insulin therapy is a real challenge. Aerobic exercise due to muscle contraction decreases blood glucose, leads to a state of relative hyperinsulinemia and generates hypoglycemia at the beginning or after, while anaerobic exercise is associated with hyperglycemia by increased catecholamines and increased lactate that promotes hepatic neoglycogenesis. The deterioration of the counterregulatory hormone response existing in type 1 diabetes amplifies glycemic variability and hinders metabolic control. There are guidelines and recommendations that seek to provide a safe framework for prescription of physical activity considering the multiplicity of sports disciplines, age and chronic complications before starting the activity. The therapeutic strategies are adjustment of carbohydrates intake, pre and post exercise of insulin therapy and intensive control of blood glucose and ketones. New insulin pump infusers and glycemic monitoring offer the possibility of split and/or suspend the insulin dose, becoming the gold standard among high performance athletes. Normal glycemic control, effortless will be possible in near future, thanks to the development of integrated models with intelligent exercise calculators, predictive capacity and “individualized learning” (artificial pancreas) that will optimize and multiply the benefits of exercise.

Keywords

• diabetes tipo 1
• control glucémico
• ejercicio
• tecnología y diabetes