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Exp Clin Endocrinol Diabetes 2023; 131(01/02): 51-60
DOI: 10.1055/a-1946-3768
German Diabetes Association: Clinical Practice Guidelines

Diabetes, Sports and Exercise

Authors

  • Katrin Esefeld

    1   Department of Preventive Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
    2   German Center for Cardiovascular Research (Deutsches Zentrum für Herzkreislaufforschung – DZHK), partner site Munich Heart Alliance (MHA), Munich, Germany

  • Stephan Kress

    3   Diabetes, Sport and Physical Activity Working Group of the DDG
    4   Department of Internal Medicine I, Vinzentius Hospital Landau, Landau, Germany

  • Meinolf Behrens

    3   Diabetes, Sport and Physical Activity Working Group of the DDG
    5   Diabetes Center Minden, Minden, Germany

  • Peter Zimmer

    3   Diabetes, Sport and Physical Activity Working Group of the DDG

  • Michael Stumvoll

    6   Department of Internal Medicine III, University Hospital Leipzig, Leipzig, Germany

  • Ulrike Thurm

    3   Diabetes, Sport and Physical Activity Working Group of the DDG

  • Bernhard Gehr

    3   Diabetes, Sport and Physical Activity Working Group of the DDG
    7   m&i specialized clinic Bad Heilbrunn, Bad Heilbrunn, Germany

  • Martin Halle   *

    1   Department of Preventive Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
    2   German Center for Cardiovascular Research (Deutsches Zentrum für Herzkreislaufforschung – DZHK), partner site Munich Heart Alliance (MHA), Munich, Germany
    3   Diabetes, Sport and Physical Activity Working Group of the DDG

  • Christian Brinkmann   *

    3   Diabetes, Sport and Physical Activity Working Group of the DDG
    8   Institute of Cardiovascular Research and Sport Medicine, German Sport University Cologne, Cologne, Germany
    9   IST University of Applied Sciences Düsseldorf, Düsseldorf, Germany
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Notice of Update

The DDG practice recommendations are updated regularly during the second half of the calendar year. Please ensure that you read and cite the respective current version.

Updates to Content and Different Recommendations Compared to The Previous Year’s Version

Recommendation 1: Update of exercise recommendations for optimal amount of physical activity in line with the 2022 recommendations of the American Diabetes Association (ADA)

Reason: Recommendations of the newly-published guidelines of the American Diabetes Association (ADA) 2022 on the amount of physical activity for people with diabetes mellitus are now taken into account.

Supporting reference: [5]

Recommendation 2: Consideration of the position paper of the European Association for the Study of Diabetes (EASD) on glucose management of patients with type 1 diabetes mellitus during sport and exercise with the support of continuous glucose monitoring systems (CGM)

Reason: CGM systems can support people with diabetes mellitus before, during and after exercise to make good choices of action. The position paper contains helpful recommendations based on scientific studies and clinical experience.

Supporting reference: [10]

Recommendation 3: Inclusion of the recommendation to stand and perform light activity to interrupt extended periods of sitting.

Reason: Studies show that prolonged sitting times increase the risk of type 2 diabetes mellitus. Frequent interruption has positive effects on glucose levels and insulin sensitivity.

Supporting reference: [40] [43]

For all forms of diabetes mellitus, exercise is one of the most important measures for maintaining good health. Sport and exercise trigger adaptation and repair mechanisms in various organ systems and cells, such as the muscles, nerves, vessels, immune system or brain, which can help ward off diseases [1] [2] [3] [4].

There is no need for maximal physical exhaustion. Exertion according to the motto “running/walking without panting” already results in good health benefits. In addition to 30 minutes of exercise per day, increasing the opportunities for being active in the context of everyday activities has also been proven to be effective. In addition to the recommendations of the American Diabetes Association (ADA) from 2022, adults with diabetes should exercise for 150 minutes/week or more at moderate intensity. Younger and physically fit patients can also exercise more intensively (minimum recommendation: 75 minutes/week). Exercise should be performed on at least 3 days, with no more than 2 consecutive days of inactivity. In addition, it is recommended to do strength training 2 to 3 times a week, but not on consecutive days. Periods of sitting should be interrupted every 30 minutes. For older people, flexibility and balance training is also recommended 2–3 times a week. Alternative sports such as yoga and tai-chi may also be suitable. For the treatment of obesity, 200–300 minutes of exercise per week and an energy deficit of about 500–750 kcal/day should be aimed for [5].

This practice guideline is intended to outline therapeutic options for physical activity in the treatment of diabetes mellitus and to provide practical recommendations for implementing these options for type 1 and type 2 patients.

* Shared senior authorship




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Artikel online veröffentlicht:
13. Januar 2023

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