Turkiye Klinikleri Journal of Sports Sciences

.: REVIEW
Tip 1 Diyabet, Egzersiz ve Beslenme
Type 1 Diabetes, Exercise and Nutrition
Emre Batuhan KENGERa, Can ERGÜNa
aBeslenme ve Diyetetik Bölümü, Bahçeşehir Üniversitesi Sağlık Bilimleri Fakültesi, İstanbul, TÜRKİYE
Turkiye Klinikleri J Sports Sci. 2019;11(3):164-70
doi: 10.5336/sportsci.2019-70286
Article Language: TR
Full Text
ÖZET
 Diyabetli bireylerin tedavisinde tıbbi beslenme tedavisi ve egzersiz, yaşam tarzı değişikliklerinin temelini oluşturmaktadır. Egzersizin olası komplikasyonlarının önlenmesi için egzersiz öncesi, sırası ve sonrasında egzersizin tipi, süresi ve yoğunluğuna göre beslenme planının yapılması gerekmektedir. Egzersiz, fiziksel uygunluğu artırmak için yapılandırılmış ve tasarlanmış daha spesifik bir fiziksel aktivite şeklidir. Egzersizin kan şekeri kontrolünü iyileştirdiği, kardiyovasküler risk faktörlerini azalttığı, kilo kaybına katkıda bulunduğu ve kişilerin daha iyi hissetmesini sağladığı gösterilmiştir. Tip 1 diyabetli kişiler tarafından yapılan çeşitli egzersiz türlerine metabolik ve nöroendokrin tepkilerinin anlaşılması, uygun beslenme ve insülin yönetimi stratejilerinin belirlenmesi için gereklidir. Tip 1 diyabette, egzersize verilen glisemik cevaplar, insülinin uygulandığı yer, dolaşımdaki insülin miktarı, egzersiz öncesi kan glukoz konsantrasyonu, son öğün veya atıştırmanın bileşimi ve yoğunluğu ile faaliyetin süresi ile ilişkilidir. Egzersiz sırasında dolaşımdaki artan insülin konsantrasyonları, hepatik glukoz üretimine göre artan glukoz atılımını teşvik eder ve lipolizi geciktirebilir. Kasların bir yakıt olarak glukoza bağımlılığını artırmaktadır. Hipoglisemi çoğu hastada aerobik egzersize başladıktan yaklaşık 45 dk içerisinde gelişmektedir. Tip 1 diyabetli hem antrenmanlı hem de antrenmansız bireylerin, aerobik egzersize başlamadan önce karbonhidrat alımını arttırmaları veya insülin dozunu azaltmaları veya her ikisini de uygulamaları gerekmektedir. Diyabetli birçok birey için, tedavi planının en zor olan kısmı ne yiyeceğini belirlemek ve bir yemek planını takip etmektir. Beslenme tedavisinin genel diyabet yönetiminde ayrılmaz bir rolü vardır ve diyabetli her birey, kişiselleştirilmiş bir beslenme planının iş birliğine dayalı gelişimi de dâhil olmak üzere sağlık ekibiyle birlikte eğitim, öz yönetim ve tedavi planlaması ile aktif olarak ilgilenmelidir.

Anahtar Kelimeler: Tip 1 diabetes mellitus; egzersiz; beslenme
ABSTRACT
 Medical nutrition therapy and exercise form the basis of lifestyle changes in the treatment of people with diabetes. In order to prevent possible complications of exercise, nutrition plan should be prepared according to type, duration and intensity of exercise before, during and after exercise. Exercise has been shown to improve blood sugar control, reduce cardiovascular risk factors, contribute to weight loss, and make people feel better. Understanding metabolic and neuroendocrine responses to various types of exercise performed by people with Type 1 diabetes is essential to identify appropriate nutritional and insulin management strategies. In Type 1 diabetes, glycemic responses to exercise are associated with the location of insulin delivery, the amount of circulating insulin, blood glucose concentration before exercise, the composition and intensity of the last meal or snack, and the duration of the activity. Increased circulating insulin concentrations during exercise promote increased glucose excretion relative to hepatic glucose production and may delay lipolysis; this increases the dependence of muscles on glucose as a fuel. Individuals with Type 1 diabetes need to increase their carbohydrate intake or reduce their insulin dose or both before starting aerobic exercise. For many people with diabetes, the most difficult part of the treatment plan is to determine what to eat and follow a meal plan. Nutritional therapy has an integral role in overall diabetes management and every individual with diabetes should actively engage in education, self-management and treatment planning with the health care team, including the cooperative development of a personalized nutrition plan.

Keywords: Tip 1 diabetes mellitus; exercise; nutrition
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