Abstract
Acute metabolic and hormonal effects of exercise were studied in 66 non-insulin-dependent diabetic patients (42 male, 24 female cases, mean age 52 y. o.). They were told to walk for 30 minutes with subjective intensity of 500 1 hour after breakfast.
In total, plasma glucose level fell from 245±80 mg/dl to 190±79 mg/dl and plasma lactate was increased from 12.8±7.6 mg/dl to 24.7±16.4 mg/dl. Non-esterified fatty acid (NEFA) and ketone-bodies showed almost no changes. As to the amino acids, only alanine increased significantly, and weak correlations were found between lactate and alanine.
Basal serum cortisol levels were slightly high (17.4±4.8 μg/dl), but exercise did not induce any significant changes. Serum growth hormone increased and serum insulin decreased significantly in response to exercise.
According to the level of plasma glucose before exercise, patients were divided into three groups; well controlled (<200 mg/dl, 22 cases), moderately controlled (200-300 mg/dl, 26 cases), poorly controlled (≥300 mg/dl, 17 cases) group. In the poorly controlled group, exercise induced minimal plasma glucose and IRI, and led to a significant rise in GH.
In the five cases, which showed a rise in plasma glucose level, metabolic indices such as lactate, NEFA, ketone-bodies and alanine before exercise were already higher, and exercise of mild intensity (mean HR: 103 bpm) led to an excessive rise in lactate, alanine and GH.
The results suggest that exercise might have adverse metabolic and hormonal effects in poorly controlled patients, so that patients should be, at least, moderately controlled before prescription of exercise.
