To study the metabolic and hormonal effect of muscular exercise on severe diabetics and to establish the biochemical criteria for physical exercise treatment for diabetic patients, paper questionnaires concerning daily physical exercise were answered by 225 diabetic patients, and treadmill exercise tests were performed after oral administration of 100g glucose in 2 severe diabetics. In both patients, fasting blood sugar levels were approximately 300 mg/dl. One patient was ketotic (basal levels 2.5-3.5 mM/l) and another was non-ketotic (0.2- 0.4 mM/l). 73 (32.5%) of the patients participated in physical exercise treatment every day and 92 (40.9%) of them did it irregularly, while 60 (26.6%) of them did not practice special physical exercise. Most of the patients did not know how to do the exercise. The rise of blood glucose and FFA in response to treadmill exercise is similar in ketotic and non-ketotic patients. In the ketotic diabetic exercise led to an additional rise in ketone body and glucagon levels, but not in non-ketotic. Therefore, exercise was a stressor, and a hypercaloraemic state induced further hypercaloraemia for the ketotic patient. After treatment for one month, blood glucose and FFA concentrations fell during and after exercise. In the well-controlled diabetic ketone body levels changed little from those of the resting state during and after exercise. It is concluded that (1) one-third of the diabetic patients did not participate in physical exercise treatment chiefly because of loss of patient education (2) in ketotic insulin deficient diabetic patients, even non-strenuous exercise can induce severely disadvantageous consequences, in contrast to the possible beneficial effects of exercise in well-controlled diabetics.
Sato et al. (Sat,) studied this question.
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