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Lebensstil: körperliche Aktivität und Training in der Prävention und Therapie des Typ 2 Diabetes mellitus (Update 2019)

  • Claudia FrancesconiEmail author
  • Josef Niebauer
  • Paul Haber
  • Raimund Weitgasser
  • Christian Lackinger
leitlinien für die praxis
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Zusammenfassung

Lebensstil, insbesondere regelmäßige körperliche Aktivität ist ein wichtiger Bestandteil in der Prävention und Therapie des Typ 2 Diabetes mellitus und sollte fester Bestandteil jeglicher Betreuung von Patienten sein. Es besteht breiter Konsens, dass eine effiziente Diabetes-Prävention und Therapie in den meisten Fällen auch von einer Modifikation des Lebensstils begleitet sein muss.

Ziele der Förderung der körperlichen Aktivität sind zunächst das Training des Herz-Kreislaufsystems, Kräftigung der Muskulatur, Steigerung des Energieverbrauchs und die Reduktion von Inaktivität. Für einen substanziellen gesundheitlichen Nutzen sind wöchentlich mindestens 150 min aerobe körperliche Aktivität mit mittlerer oder höherer Intensität und zusätzlich muskelkräftigende Bewegungen erforderlich.

Der positive Effekt von Bewegung steht in direktem Verhältnis zum Grad der erreichten kardiorespiratorischen Fitness, der erreicht wird. und hält nur so lange an, wie diese aufrechterhalten werden kann. Der Effekt von Bewegung ist alters- und geschlechtsunabhängig und reproduzierbar. Körperliches Training im Speziellen hat die Potenz nicht nur positiven Einfluss auf die Glykämie durch Verbesserung der Insulinresistenz und funktionelle Verbesserung der Insulinsekretion zu nehmen, sondern ist auch in der Lage, das kardiovaskuläre Risiko zu senken.

Inaktivität per se gilt unabhängig vom Konstrukt der körperlichen Aktivität als Risikofaktor. Insbesondere langandauernde sitzende Tätigkeit soll vermieden werden.

Angeleitete Bewegungsprogramme sind bestens geeignet, um ein ausreichendes wöchentliches Ausmaß an gesundheitsfördernder körperlicher Aktivität zu erreichen. Großes Potential liegt in standardisierten, regionalen Bewegungsangeboten, jedoch gibt es aktuell noch viele Barrieren in der Verordnung von körperlicher Aktivität. Um dieser Herausforderung gerecht zu werden, fordert die Österreichische Diabetes Gesellschaft die Position des Bewegungsberaters als fixen Bestandteil eines multidisziplinären Behandlungsansatzes.

Schlüsselwörter

Körperliche Aktivität Inaktivität Standardisierte Bewegungsprogramme Kardiovaskuläres Risiko Bewegungsberatung 

Lifestyle: physical activity and training as prevetion and therapy of type 2 diabetes mellitus (Update 2019)

Summary

Lifestyle in general and particularly health enhancing physical activity is known to be an important component in the prevention and therapy of type 2 diabetes mellitus.

To gain substantial health benefits a minimum of 150 min of moderate or vigorous intense aerobic physical activity and muscle strengthening activities per week are needed. Additionally, inactivity should be recognised as health hazard and prolonged episodes of sitting should be avoided.

Exercise in particular is not only useful in improving glycaemia by lowering insulin resistance and positively affect insulin secretion, but to reduce cardiovascular risk. The positive effect of training correlates directly with the amount of fitness gained and lasts only as long as the fitness level is sustained. The effect of exercise is independent of age and gender. It is reversible and reproducible.

Supervised exercise classes are well known to be attractive for adults to reach a sufficient level of health enhancing physical activity. The potential of regional, standardised exercise programmes could have been shown, although existing barriers to entry must be reduced. To tackle this public health challenge and based on the large evidence of exercise referral and prescription the Austrian Diabetes Associations aims to implement the position of a “physical activity adviser” in multi-professional diabetes care.

Keywords

Health enhancing physical activity Standardised exercise programme Cardiovascular risk Physical activity counselling 

Notes

Interessenkonflikt

C. Francesconi, J. Niebauer, P. Haber, R. Weitgasser und C. Lackinger geben an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Claudia Francesconi
    • 1
    Email author
  • Josef Niebauer
    • 2
  • Paul Haber
    • 3
  • Raimund Weitgasser
    • 4
  • Christian Lackinger
    • 5
  1. 1.Sonderkrankenanstalt Rehabilitationszentrum AllandAllandÖsterreich
  2. 2.Universitätsinstitut für Präventive und Rehabilitative Sportmedizin, Landeskrankenhaus Salzburg – UniversitätsklinikumParacelsus Medizinische PrivatuniversitätSalzburgÖsterreich
  3. 3.Universitätsklinik für Innere Medizin IIMedizinische Universität WienWienÖsterreich
  4. 4.Abteilung für Innere MedizinPrivatklinik Wehrle-DiakonissenSalzburgÖsterreich
  5. 5.Österreichische Gesellschaft für Public HealthWienÖsterreich

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