健走運動對第二型糖尿病中高齡患者之健康效益

Health Benefits of Walking Exercise in Middle-Aged and Older Patients With Type 2 Diabetes

10.6162/SRR.202203_(160).0003

陳姿吟(Tzu-Yin Chen)；黃月桂(Yueh-Guey Huang)

生活型態 ； 健康生活品質 ； 公共衛生 ； 血糖 ； 身體活動量 ； lifestyle ； healthy quality of life ； public health ； physical activity ； blood sugar

大專體育

160期（2022 / 03 / 31）

31 - 40

繁體中文

臺灣人口老化的影響使得第二型糖尿病盛行率持續攀升，如何改善中高齡患者之生活型態以維持健康生活品質儼然成為公共衛生的挑戰。本文綜整有關健走運動介入第二型糖尿病中高齡患者的實證性研究，目的在瞭解健走運動對第二型糖尿病中高齡患者的健康效益，以提供未來擬定運動行為與健康促進策略之參考。整體而言，健走運動介入被證實可有效降低第二型糖尿病患發生心血管疾病相關併發症之風險。第二型糖尿病中高齡患者會因社區夥伴支持而參與健走運動以維持運動動機及提升生活品質。研究結語指出本文以證據為基礎，歸納出健走運動應用於第二型糖尿病中高齡患者的健康與行為，包含：增加運動時間與頻率、提升運動強度及身體活動量，並且促進社區夥伴關懷與支持。透過此策略將能有效促進血糖控制、改善血液指標、提升能量消耗與健康生活品質。即便如此，目前健走運動介入針對中高齡糖尿病患的研究證據仍然不多，建議未來可透過穿戴式裝置評估身體活動量，以詳細探討健走運動對中高齡糖尿病患不同健康效益之影響。

The aging of Taiwan's population has brought about a constant rising prevalence of type 2 diabetes. Improving the lifestyle of middle-aged and older adults to maintain a healthy quality of life has become a public health challenge. The purpose of this article is thus to summarize the empirical studies on the intervention of walking exercise in middle-aged and older patients with type 2 diabetes, to understand its health benefits and potential mechanisms for the target group, and then hopefully to provide a reference for future strategies in exercise behavior and health promotion. Overall, the intervention of walking exercises has been proven to effectively reduce the risk of cardiovascular disease-related complications in patients with type 2 diabetes. Members of the target population could participate in walking exercises with community partners' support to maintain their motivation and improve their quality of life. Based on the evidence-based articles, this article summarizes the health and behavior of walking exercise applied to older patients with type 2 diabetes and offers suggestions, including: increasing physical activity; increasing exercise duration, frequency, and intensity; and promoting community-based peer caring and support. Walking exercise could effectively promote blood sugar control, improve blood indicators, increase energy consumption, and improve quality of life. However, there is still not much research evidence on the intervention of walking exercises for middle-aged and elderly diabetic patients. Future studies could incorporate wearable devices to assess physical activity levels and explore the impact of walking exercises on health benefits among middle-aged and elderly diabetic patients.

1. 甘能斌, N.-P.,黃錦源, J.-Y.,洪彰岑, C.-T.(2016)。第二型糖尿病前期患者生活型態介入治療與雲端科技之應用。大專體育，137，45-53。
   連結：
2. 林芳子, F.-T.,張琪, C.,李昭憲, C.-H.,楊燦, T.(2011)。社區型中老年人健走運動介入對生活品質影響之研究。醫護科技期刊，13(4)，227-240。
   連結：
3. Albright, A.,Franz, M.,Hornsby, G.,Kriska, A.,Marrero, D.,Ullrich, I.,Verity, L. S.(2000).American College of Sports Medicine position stand. Exercise and type 2 disabilities.Medicine and Science in Sports and Exercise,32(7),1345-1360.
4. American College of Sports Medicine(2003).ACSM’s exercise management for persons with chronic diseases and disabilities.Champaign, IL:Human Kinetics.
5. American Diabetes Association(2004).Physical activity/exercise and diabetes.Diabetes Care,27(Suppl. 1),S58-S62.
6. Bellary, S.,Kyrou, I.,Brown, J. E.,Bailey, C. J.(2021).Type 2 diabetes mellitus in older adults: Clinical considerations and management.Nature Reviews Endocrinology,17(9),534-548.
7. Bull, F. C.,Al-Ansari, S. S.,Biddle, S.,Borodulin, K.,Buman, M. P.,Cardon, G.,Willumsen, J. F.(2020).World Health Organization 2020 guidelines on physical activity and sedentary behaviour.British Journal of Sports Medicine,54(24),1451-1462.
8. Cai, H.,Li, G.,Zhang, P.,Xu, D.,Chen, L.(2017).Effect of exercise on the quality of life in type 2 diabetes mellitus: A systematic review.Quality of Life Research,26(3),515-530.
9. Cassilhas, R. C.,Viana, V. A.,Grassmann, V.,Santos, R. T.,Santos, R. F.,Tufik, S.,Mello, M. T.(2007).The impact of resistance exercise on the cognitive function of the elderly.Medicine & Science in Sports & Exercise,39(8),1401-1407.
10. Chiu, L.-L.,Chou, S.-W.,Cho, Y.-M.,Ho, H.-Y.,Ivy, J. L.,Hunt, D.,Kuo, C.-H.(2004).Effect of prolonged intermittent hypoxia and exercise training on glucose tolerance and muscle GLUT4 protein expression in rats.Journal of Biomedical Science,11(6),838-846.
11. Ferriolli, E.,Pessanha, F. P. A. S.,Marchesi, J. C. L. S.(2014).Diabetes and exercise in the elderly.Medicine and Sport Science,60,122-129.
12. Fritz, T.,Caidahl, K.,Krook, A.,Lundström, P.,Mashili, F.,Osler, M.,Zierath, J. R.(2013).Effects of Nordic walking on cardiovascular risk factors in overweight individuals with type 2 diabetes, impaired or normal glucose tolerance.Diabetes/Metabolism Research and Reviews,29(1),25-32.
13. Fritz, T.,Caidahl, K.,Osler, M.,Östenson, C. G.,Zierath, J. R.,Wändell, P.(2011).Effects of Nordic walking on health-related quality of life in overweight individuals with type 2 diabetes mellitus, impaired or normal glucose tolerance.Diabetic Medicine,28(11),1362-1372.
14. Jiang, Y.,Tan, S.,Wang, Z.,Guo, Z.,Li, Q.,Wang, J.(2020).Aerobic exercise training at maximal fat oxidation intensity improves body composition, glycemic control, and physical capacity in older people with type 2 diabetes.Journal of Exercise Science & Fitness,18(1),7-13.
15. Karstoft, K.,Winding, K.,Knudsen, S. H.,Nielsen, J. S.,Thomsen, C.,Pedersen, B. K.,Solomon, T. P. J.(2013).The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: A randomized, controlled trial.Diabetes Care,36(2),228-236.
16. Kleinloog, J. P. D.,Mensink, R. P.,Ivanov, D.,Adam, J. J.,Uludağ, K.,Joris, P. J.(2019).Aerobic exercise training improves cerebral blood flow and executive function: A randomized, controlled cross-over trial in sedentary older men.Frontiers in Aging Neuroscience,11,333.
17. Mendes, R.,Sousa, N.,Themudo-Barata, J.,Reis, V.(2016).Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes.Gaceta Sanitaria,30(3),215-220.
18. Moghetti, P.,Balducci, S.,Guidetti, L.,Mazzuca, P.,Rossi, E.,Schena, F.(2021).Walking for subjects with type 2 diabetes: A systematic review and joint AMD/SID/SISMES evidence-based practical guideline.Sport Sciences for Health,17(1),1-20.
19. National Institutes of Health. (2014, November). Preventing type 2 diabetes: Steps toward a healthier life. NIH News in Health. Retrieved from https://newsinhealth.nih.gov/2014/11/preventing-type-2-diabetes
20. Nelson, M. E.,Rejeski, W. J.,Blair, S. N.,Duncan, P. W.,Judge, J. O.,King, A. C.,Castaneda-Sceppa, C.(2007).Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association.Medicine & Science in Sports & Exercise,39(8),1435-1445.
21. Parkatti, T.,Perttunen, J.,Wacker, P.(2012).Improvements in functional capacity from Nordic walking: A randomized-controlled trial among older adults.Journal of Aging and Physical Activity,20(1),93-105.
22. Pippi, R.,Di Blasio, A.,Aiello, C.,Fanelli, C.,Bullo, V.,Gobbo, S.,Bergamin, M.(2020).Effects of a supervised Nordic walking program on obese adults with and without type 2 diabetes: The C.U.R.I.A.Mo. Centre experience.Journal of Functional Morphology and Kinesiology,5(3),62.
23. Qiu, S.,Cai, X.,Schumann, U.,Velders, M.,Sun, Z.,Steinacker, J. M.,Manzoli, L.(2014).Impact of walking on glycemic control and other cardiovascular risk factors in type 2 diabetes: A meta-analysis.PLoS ONE,9(10),e109767.
24. Sato, Y.(2020).Overview of exercise prescription for diabetes patients and its application in Japan.Journal of Science in Sport and Exercise,2(3),226-235.
25. Sheen, Y.-J.,Hsu, C.-C.,Jiang, Y.-D.,Huang, C.-N.,Liu, J.-S.,Sheu, H.-H.(2019).Trends in prevalence and incidence of diabetes mellitus from 2005 to 2014 in Taiwan.Journal of Formosan Medical Association,118,S66-S73.
26. Sung, K.,Bae, S.(2012).Effects of a regular walking exercise program on behavioral and biochemical aspects in elderly people with type II diabetes.Nursing & Health Sciences,14(4),438-445.
27. Tschentscher, M.,Niederseer, D.,Niebauer, J.(2013).Health benefits of Nordic walking: A systematic review.American Journal of Preventive Medicine,44(1),76-84.
28. Tudor-Locke, C.,Bell, R. C.,Myers, A. M,Harris, S. B.,Ecclestone, N. A.,Lauzon, N.,Rodger, N. W.(2004).Controlled outcome evaluation of the First Step Program: A daily physical activity intervention for individuals with type II diabetes.International Journal of Obesity,28(1),113-119.
29. Upeniece, I.,Smite, D.,Arnis, V.(2014).Nordic walking for patients of type II diabetes mellitus: A critical review.Education in a Changing Society,1,108-112.
30. Yakaryılmaz, F. D.,Öztürk, Z. A.(2017).Treatment of type 2 diabetes mellitus in the elderly.World Journal of Diabetes,8(6),278-285.
31. 中華民國糖尿病衛教學會（2019）。臺灣糖尿病年鑑─2019 第 2 型糖尿病。臺北市：作者。[Taiwanese Association of Diabetes Educators. (2019). Annals of diabetes mellitus in Taiwan-2019 update on type 2 diabetes. Taipei, Taiwan: Author.]
32. 李薇萱, W.-X.,羅于韵, Y.-Y.,杜俊毅, J.-Y.(2009)。老年人的運動處方。基層醫學，24(1)，8-13。
33. 張伯輝, B.-H.,呂欣善, S.-S.(2015)。北歐式健走運動對老年人功能性體適能之影響。中洲學報，29，143-155。
34. 楊昌斌, C.-B.,黃智能, Z.-N.,張少遜, S.-S.,曹德弘, T.-H.(2008)。第二型糖尿病患者運動介入的理論與應用。基層醫學，23(2)，55-60。