title: Exercise in diabetes: therapeutic implications.
abstract: The metabolic response to acute exercise in diabetics is largely determined by the availability of insulin. In nonketotic, insulin-dependent diabetics, acute exercise lowers the level of plasma glucose, whereas in insulin-deficient, ketotic patients, blood glucose may increase during exercise. Exercise accelerates insulin absorption from the exercising limb. Thus, by injecting insulin into a nonexercising area (eg, into the abdomen before leg exercise), the degree of exercise-induced hypoglycemia can be reduced in diabetic patients. Also, elevation in the level of antiinsulin hormones caused by exercise is exaggerated in diabetics if insulin treatment is less than optimal. This abnormal hormonal response may be restored to normal by improved methods of insulin delivery. In normal subjects, regular exercise or training results in enhanced body sensitivity to insulin. This rise in sensitivity may be mediated by augmented insulin binding to receptors. Furthermore, regular exercise may decrease levels of serum triglycerides and low-density lipoprotein cholesterol and increase those of high-density lipoprotein cholesterol. These beneficial effects of training on carbohydrate and lipid metabolism observed in normal subjects may extend to diabetic patients as well.
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control; D007328:Insulin / Q000378:metabolism / Q000627:therapeutic use; D009132:Muscles / Q000378:metabolism; D005082:Physical Exertion
chemical_list: D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin