Những hướng dẫn này trở nên phức tạp hơn cho người có bệnh tiểu đường type 2, mà một số loại tập thể dục có thể được chống chỉ định do cao huyết áp, bệnh tim, béo phì, kiểm soát đường huyết, thuốc men, bệnh võng mạc, thần kinh ngoại biên. | 136 Consitt et al. 3-4 d per week and intensities anywhere from walking to more intense jogging running . These guidelines become even more complex for the person with type 2 diabetes for whom certain types of exercise may be contraindicated owing to hypertension heart disease obesity blood glucose control medications retinopathy or peripheral neuropathy. This chapter summarizes research describing the effect of either aerobic- . endurance or resistance- . weight lifting oriented exercise training on insulin action leading to enhanced metabolic control in patients with type 2 diabetes. This information will provide a foundation for the development of safe and effective exercise prescriptions. Although general contraindications for exercise will be discussed a major assumption inherent in this chapter is that the diabetic subjects performing exercise were properly cleared by a physician for initiating physical activity. AEROBIC EXERCISE Because type 2 diabetes is associated with hyperglycemia and insulin resistance and skeletal muscle is a main source of glucose uptake 2 clinical exercise research has focused on therapeutic methods of reducing elevated glucose levels and improving insulin action. The measured improvements in insulin action may be owing to either the chronic effects of training or simply the residual effect of the last bout of exercise. Studies of healthy endurance trained males as well as individuals with type 2 diabetes have shown that improved insulin sensitivity is maintained up to 16 h after a single bout of exercise 3 4 but may be diminished 60 h after the final exercise session during repeated days of exercise training 5 . In spite of this finding glucose uptake is greater in aerobically trained skeletal muscle than in untrained muscle 6 . Therefore to obtain optimal results patients with type 2 diabetes should exercise multiple days per week and thus obtain both the acute and chronic benefits of exercise. Several definitions are .
