低氧環境運動對第一型糖尿病患者血糖變化之影響

Hypoxic Exercise Affects Blood Glucose Levels in Type 1 Diabetes Miletus Patients

10.6162/SRR.202212_(163).0004

朱珮辰(Pei-Chen Chu)；錢桂玉(Kuei-Yu Chien)

登山健行 ； 持續訓練 ； 間歇訓練 ； 低血糖 ； 糖化血色素 ； hiking ； continuous training ； interval training ； hypoglycemia ； glycated hemoglobin

大專體育

163期（2022 / 12 / 31）

41 - 51

繁體中文;英文

血糖管理是第一型糖尿病患者生存最重要的事，可透過運動達到良好的血糖控制，並降低慢性併發症的風險，然而，至今仍缺乏低氧環境運動對第一型糖尿病患者血糖變化之影響的系統性文獻回顧。本文目的以系統性文獻回顧方式，探討第一型糖尿病患者低氧環境進行單次運動對血糖恆定之影響。以type 1 diabetes, hypoxia, hypoxic, hypoxemia, low oxygen, altitude, hiking, exercise, aerobic exercise, endurance exercise, strength exercise, resistance training為關鍵詞搜尋1985～2023年PubMed及EBSCO資料庫之原創性研究。搜尋到17篇，排除無固定氧氣濃度8篇、長時間暴露2篇及訓練1篇，共計6篇納入探討，其中5篇低氧實驗室，1篇戶外文獻。分析結果顯示：於氧氣濃度15.1%進行40分鐘65%最大心跳率中等強度持續訓練，血糖下降42%，為氧氣濃度20.1%之常氧環境的1.6倍。氧氣濃度下降至12.1%進行60分鐘45%攝氧峰值持續訓練，血糖下降為常氧環境的1.5倍。若於氧氣濃度15.1%進行4組5分鐘高強度間歇訓練，血糖下降31%，與常氧環境下降37%幅度相近，且發生低血糖事件顯著低於常氧環境。結論：第一型糖尿病患者在12.1%～15.2%氧氣濃度之低氧環境（相當於海拔2,500～4,200公尺）運動，血糖下降為常氧環境的1.4～1.6倍，且於15.1%氧氣濃度之低氧環境高強度間歇訓練，血糖下降效應與常氧環境相似，但其低血糖發生率低於常氧環境高強度間歇訓練。

Blood glucose management is the most important survival skill among patients with type 1 diabetes mellitus (T1DM). Good homeostasis management that will reduce the risk of chronic complications can be achieved through exercise. However, no systematic literature review was found for the effects of single-bout exercise in a hypoxic environment on blood sugar changes in patients with T1DM. To address that lacuna, seventeen original studies dated between 1985 and 2023 were selected using type 1 diabetes, hypoxia, hypoxic, hypoxemia, low oxygen, altitude, hiking, exercise, aerobic exercise, endurance exercise, strength exercise, and resistance training as keywords to query the PubMed and EBSCO databases. Six studies were selected and analyzed after excluding others due to the lack of fixed oxygen level (8 articles), focusing on prolonged exposure (2 articles), and training (1 article). Five of the selected studies were conducted in a hypoxic laboratory, and one was conducted outdoors. The results indicate that: 40-min continuous moderate-intensity training at 65% maximum heart rate with an oxygen concentration of 15.1% reduced blood sugar by 42%, which was 1.6 times that in a normoxic environment with an oxygen concentration of 20.1%. The oxygen concentration dropped to 12.1% for 60-min continuous training at 45% of the peak oxygen intake, and the glucose level dropped to 1.5 times that of the normoxic environment. Four sets of 5-min high-intensity interval training under 15.1% O_2 led to a 31% decrease in the glucose level, which is similar to the 37% decrease under normoxic conditions. However, exercise under 15.1% O_2 resulted in lower hypoglycemic events. If four sets of 5-min high-intensity interval training were performed at an oxygen concentration of 15.1%, the glucose level decreased by 31%, which was similar to the 37% decrease in the normoxic environment. Moreover, the hypoglycemic events were significantly lower than those in the normoxic environment. In conclusion, when patients with T1DM exercised at 12.1%-15.2% O_2 (2,500-4,200 m above sea level), their blood glucose level declined by 1.4-1.6 times compared with that in normoxic conditions. Moreover, the decrease in blood glucose following high-intensity interval training under 15.1% O_2 is similar to that in normoxic conditions, but the incidence of hypoglycemia is lower than that in normoxic conditions among patients with T1DM.

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