Diabetes, Sport und Bewegung

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Bewegung ist für alle Formen des Diabetes mellitus eine der wichtigsten Maßnahmen, die Gesundheit zu erhalten. Durch Sport und Bewegung werden Anpassungs- und Reparaturmechanismen in verschiedenen Organsystemen und Zellen wie der Muskulatur, den Nerven, Gefäßen, im Immunsystem oder Gehirn ausgelöst, die helfen können, Krankheiten abzuwehren [1] [2] [3] [4].

Es muss dabei keine körperliche Höchstleistung erbracht werden. Belastungen nach dem Motto „Laufen ohne Schnaufen“ bringen bereits gute Gesundheitsergebnisse. Neben einer Bewegung von einer halben Stunde pro Tag möglichst zusätzlich zur Alltagstätigkeit wird als effektiver Ansatz auch die Ausweitung der Chancen für Bewegung im Rahmen der Alltagstätigkeiten empfohlen. Nach den Empfehlungen der American Diabetes Association (ADA) aus dem Jahr 2023 sollen sich Erwachsene mit Diabetes 150 Minuten und mehr in moderater Intensität pro Woche bewegen. Jüngere und körperlich fitte Patienten können sich auch intensiver belasten (Mindestempfehlung: 75 Minuten/Woche). Die Bewegung sollte verteilt sein auf mindestens 3 Tage, wobei nicht mehr als 2 bewegungsarme Tage hintereinander liegen sollten. Außerdem wird empfohlen, 2- bis 3-mal pro Woche Krafttraining durchzuführen, aber nicht an aufeinanderfolgenden Tagen. Sitzphasen sollen alle 30 Minuten unterbrochen werden. Für Ältere wird 2- bis 3-mal pro Woche zusätzlich Flexibilitäts- und Gleichgewichtstraining empfohlen. Auch alternative Sportarten wie Yoga und Tai-Chi können geeignet sein. Zur Adipositasbehandlung sind Bewegungsumfänge von 200 bis 300 Minuten pro Woche und ein Energiedefizit von ca. 500 bis 750 kcal/Tag anzustreben [5].

Diese Praxisleitlinie soll die pathophysiologischen Hintergründe und therapeutischen Optionen zur Bedeutung von körperlicher Aktivität in der Therapie des Diabetes mellitus in Grundzügen umreißen und praktische Empfehlungen für die Umsetzung bei Typ-1- und Typ-2-Patienten geben.

^* Geteilte Senior-Autorenschaft.

Publication History

Article published online:
30 October 2023

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