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DOI: 10.1055/a-2592-8335
Diabetes, Sport und Bewegung
Authors
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Neuerung 1: Aktualisierung der Bewegungsempfehlungen für ein optimales Bewegungspensum gemäß den Empfehlungen der American Diabetes Association (ADA) für das Jahr 2025.
Begründung: Empfehlungen der neu erschienenen Guidelines der ADA 2025 werden nun berücksichtigt.
Stützende Quellenangabe: [1]
Neuerung 2: Hinweis auf neues Position Statement der European Association for the Study of Diabetes (EASD) und der International Society for Pediatric and Adolescent Diabetes (ISPAD) mit Empfehlungen zur individuellen Nutzung kommerziell erhältlicher AID Systeme.
Begründung: Das neue EASD und ISPAD Position Statement kann für Personen mit Typ-1-Diabetes mellitus äußerst hilfreich sein, Einstellungen vorzunehmen und ihre AID Systeme im Zusammenhang mit Sport optimal zu nutzen.
Stützende Quellenangabe: [2]
Neuerung 3: Anmerkungen zum Einsatz von Wocheninsulin (Insulin Icodec) im Kontext von Sport.
Begründung: Eine Dosisreduktion für Sport ist nicht möglich, daher müssen ggf. die Menge des Bolusinsulins reduziert werden und/oder Zusatz-Kohlenhydrate eingenommen werden.
Stützende Quellenangabe: [3]
Neuerung 4: Veränderung des erwarteten Glukosetrends nach anaeroben Belastungen.
Begründung: Neue Studiendaten zeigen, dass bei anaeroben Belastungen der Glukosewert bei Belastung oft zunächst auch abfällt.
Stützende Quellenangabe: [4]
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 [5] [6] [7] [8].
Es muss dabei keine körperliche Höchstleistung erbracht werden. Belastungen nach dem Motto „Laufen ohne Schnaufen“ bringen bereits gute Gesundheitsergebnisse. Neben gezielten Bewegungsmaßnahmen wird als effektiver Ansatz auch die Ausweitung der Chancen für Bewegung im Rahmen der Alltagsaktivitäten empfohlen. Nach den Empfehlungen der American Diabetes Association (ADA) aus dem Jahr 2025 sollen sich Erwachsene mit Diabetes 150 Minuten und mehr in moderater Intensität pro Woche bewegen. Jüngere und körperlich fitte Personen 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 [1]. Für Kinder und Jugendliche gilt eine Empfehlung für moderate bis anstrengende Bewegung von mindestens 60 Minuten Dauer/Tag [1].
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 Menschen mit Typ-1 und Typ-2 Diabetes geben.
Publication History
Received: 26 June 2025
Accepted: 09 October 2025
Article published online:
24 December 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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